MEDICARE: MASVIDA HEALTH CARE SOLUTIONS 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

General Provider Information

NPI Number	:	1861046351
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MASVIDA HEALTH CARE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	133 NURSERY LN
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76114-4390
Country	:	US
Telephone Number	:	877-790-5994
Fax Number	:	817-447-8855

Provider Business Practice Location Address
First Line	:	158 BEAR CAT RD STE B
Second Line	:
City	:	ALEDO
State	:	TX
Zip	:	76008-3214
Country	:	US
Telephone Number	:	682-319-6980
Fax Number	:

Authorized Official
Title or Position	:	HR DIRECTOR
Name	:	JOSEPH VIEIRA
Credential	:
Telephone Number	:	817-697-7119

Provider Enumeration Date	:	08/01/2019
Last Update Date	:	10/12/2021

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