1699831131 NPI number — MID-CITIES HOME MEDICAL EQUIPMENT CO. INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699831131 NPI number — MID-CITIES HOME MEDICAL EQUIPMENT CO. INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MID-CITIES HOME MEDICAL EQUIPMENT CO. INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699831131
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
304 RED HAWK DR.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAND PRAIRIE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75052
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-641-7445
Provider Business Mailing Address Fax Number:
972-641-7465

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2112 RUTLAND DR
Provider Second Line Business Practice Location Address:
STE 176
Provider Business Practice Location Address City Name:
AUSTIN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78758
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-837-2533
Provider Business Practice Location Address Fax Number:
512-837-0135
Provider Enumeration Date:
12/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MONTHEY
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OPERATIONS MGR.
Authorized Official Telephone Number:
972-641-7445

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  0010654 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X , with the licence number: 0036337 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 531150 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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