MEDICARE: INTERNATIONAL HEALTHCARE SUPPLIES & EQUIPMENT INC

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	1000320	TX

General Provider Information

NPI Number	:	1265750517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERNATIONAL HEALTHCARE SUPPLIES & EQUIPMENT INC

Provider Business Mailing Address
First Line	:	2716 COUNTY ROAD 804A
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-1950
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 PHYSICANS BLVD STE F
Second Line	:
City	:	ENNIS
State	:	TX
Zip	:	75119-6248
Country	:	US
Telephone Number	:	817-800-5630
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JASON MOSES
Credential	:
Telephone Number	:	817-800-5630

Provider Enumeration Date	:	05/11/2010
Last Update Date	:	05/11/2010

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