MEDICARE: RYRIE MANAGEMENT SUPPLIES 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	1001597	TX

General Provider Information

NPI Number	:	1720463615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RYRIE MANAGEMENT SUPPLIES LLC

Provider Business Mailing Address
First Line	:	1400 BROADFIELD BLVD
Second Line	:	STE. 200
City	:	HOUSTON
State	:	TX
Zip	:	77084-5163
Country	:	US
Telephone Number	:	281-994-7831
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 BROADFIELD BLVD
Second Line	:	STE. 200
City	:	HOUSTON
State	:	TX
Zip	:	77084-5163
Country	:	US
Telephone Number	:	281-994-7831
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	STEPHEN RICHARDSON
Credential	:
Telephone Number	:	281-994-7831

Provider Enumeration Date	:	07/21/2015
Last Update Date	:	07/21/2015

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