MEDICARE: ACCESS MEDIQUIP, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1205145844
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS MEDIQUIP, LLC

Provider Business Mailing Address
First Line	:	2724 MOMENTUM PL
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60689-0001
Country	:	US
Telephone Number	:	713-985-4850
Fax Number	:	713-985-4875

Provider Business Practice Location Address
First Line	:	6002 ROGERDALE RD
Second Line	:	SUITE 300
City	:	HOUSTON
State	:	TX
Zip	:	77072-1655
Country	:	US
Telephone Number	:	713-985-4850
Fax Number	:	713-985-4875

Authorized Official
Title or Position	:	PRESIDENT AND COO
Name	:	MR. WILLIAM H ELLIOTT
Credential	:
Telephone Number	:	713-985-4850

Provider Enumeration Date	:	09/30/2010
Last Update Date	:	09/30/2010

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