EAGLE PASS HOME MEDICAL SUPPLY LLC NPI 1588646863

NPI Information

NPI: 1588646863
Provider Name: EAGLE PASS HOME MEDICAL SUPPLY LLC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Address:
2822 N VETERANS BLVD STE C
EAGLE PASS, TX
ZIP 78852
Phone: (830) 773-0171
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EAGLE PASS HOME MEDICAL SUPPLY LLC is a durable medical equipment medical supplies in Eagle Pass, TX. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. EAGLE PASS HOME MEDICAL SUPPLY LLC NPI is 1588646863. The provider is registered as an organization entity type.

The provider's business location address is:

2822 N VETERANS BLVD STE C
EAGLE PASS, TX
ZIP 78852-819
Phone: (830) 773-0171
Fax: (830) 757-0789

The provider's authorized official is Kenneth Edward Wiese .
The authorized official title is General Manager and has the following contact phone number (830) 775-4060.

The enumeration date for this NPI number is 11/14/2005 and was last updated on 10/20/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	332BP3500X	Durable Medical Equipment & Medical Supplies	Parenteral & Enteral Nutrition	0082296	TEXAS	No
2	332BX2000X	Durable Medical Equipment & Medical Supplies	Oxygen Equipment & Supplies			No
3	332B00000X	Durable Medical Equipment & Medical Supplies				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	175884902	MEDICAID	TEXAS
2	5503120001	MEDICARE ID-TYPE UNSPECIFIED		MEDICARE PROVIDER ID
3	507642	OTHER	TEXAS	INSURANCE PROVIDER ID
4	175884901	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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