MEDICARE: SCOOTERS WHEELCHAIRS TOO, 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	1--9	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	530798	OTHER	TX	BLUE CROSS BLUE SHIELD ID

General Provider Information

NPI Number	:	1699770891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOOTERS WHEELCHAIRS TOO, INC.

Provider Business Mailing Address
First Line	:	1712 W MAIN ST
Second Line	:
City	:	GUN BARREL CITY
State	:	TX
Zip	:	75156-4398
Country	:	US
Telephone Number	:	903-887-2221
Fax Number	:	903-887-2228

Provider Business Practice Location Address
First Line	:	1712 W MAIN ST
Second Line	:
City	:	GUN BARREL CITY
State	:	TX
Zip	:	75156-4398
Country	:	US
Telephone Number	:	903-887-2221
Fax Number	:	903-887-2228

Authorized Official
Title or Position	:	OWNER
Name	:	MR. BYRON K GREEN
Credential	:
Telephone Number	:	903-887-2221

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	07/21/2022

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