MEDICARE: DURABLE MEDICAL 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699770115
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DURABLE MEDICAL EQUIPMENT, INC.

Provider Business Mailing Address
First Line	:	3900 MEDICAL PKWY
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-4004
Country	:	US
Telephone Number	:	512-454-8663
Fax Number	:	512-454-8665

Provider Business Practice Location Address
First Line	:	3900 MEDICAL PKWY
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-4004
Country	:	US
Telephone Number	:	512-454-8663
Fax Number	:	512-454-8665

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BRENT EDWARD BRADSHAW
Credential	:
Telephone Number	:	512-454-8663

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	06/01/2012

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