MEDICARE: DURABLE MEDICAL EQUIPMENT RENTAL & SALES 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	05001890	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	510-53412	OTHER	AL	BLUE CROSS AND BLUE SHIELD

General Provider Information

NPI Number	:	1831196591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DURABLE MEDICAL EQUIPMENT RENTAL & SALES INC

Provider Business Mailing Address
First Line	:	244 WOODBRIDGE LN
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-7112
Country	:	US
Telephone Number	:	205-991-1006
Fax Number	:

Provider Business Practice Location Address
First Line	:	3600 5TH AVE S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35222-2402
Country	:	US
Telephone Number	:	205-591-0817
Fax Number	:	205-591-3734

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. PETE ALLEN III
Credential	:
Telephone Number	:	205-591-0817

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	04/30/2008

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