Eagle Pass Home Medical Supply Llc

LBN: Eagle Pass Home Medical Supply Llc
Eagle Pass Home Medical Supply Llc is an health care organization with primary practice located at 2822 N Veterans Blvd Ste C , Eagle Pass TX 78852-4819. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Parenteral & Enteral Nutrition, Suppliers / Oxygen Equipment & Supplies. Suppliers / Durable Medical Equipment & Medical Supplies is the primary health care specialty. Eagle Pass Home Medical Supply Llc can be contacted via phone (830) 773-0171, or through Wiese, Kenneth Edward via phone (830) 775-4060.

Contact Information

Primary practice address
2822 N Veterans Blvd Ste C Eagle Pass TX 78852-4819
Phone: (830) 773-0171
Fax: (830) 757-0789
Website:
Map and Directions
Authorized official contact:
Name: Wiese, Kenneth Edward
Phone: (830) 775-4060

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Parenteral & Enteral Nutrition 332BP3500X 0082296 Texas
Suppliers / Oxygen Equipment & Supplies 332BX2000X

Profile Details

NPI number 1588646863
LBN Legal business name Eagle Pass Home Medical Supply Llc
DBA Doing business as
Authorized official Wiese, Kenneth Edward
Entity Organization
Organization subpart 1 No
Enumeration date Nov 14th, 2005
Last updated Oct 20th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588646863 NPPES
Texas MEDICAID 175884902
Texas MEDICAID 175884901
Texas Other 507642

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