MEDICARE: PLATINUM DME, 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	0086488	TX

General Provider Information

NPI Number	:	1598700874
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLATINUM DME, LLC

Provider Business Mailing Address
First Line	:	10449 E CLOVER LN
Second Line	:
City	:	FORNEY
State	:	TX
Zip	:	75126-7915
Country	:	US
Telephone Number	:	972-564-6511
Fax Number	:

Provider Business Practice Location Address
First Line	:	9330 AMBERTON PKWY
Second Line	:	STE. 1220
City	:	DALLAS
State	:	TX
Zip	:	75243-3278
Country	:	US
Telephone Number	:	214-389-1907
Fax Number	:	214-389-1908

Authorized Official
Title or Position	:	OWNER/MEMBER
Name	:	SAMUEL N DIMSON
Credential	:
Telephone Number	:	214-213-3952

Provider Enumeration Date	:	06/19/2006
Last Update Date	:	08/22/2020

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