MEDICARE: STIMULUS DME 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	0106342	TX

General Provider Information

NPI Number	:	1871746545
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STIMULUS DME LLC

Provider Business Mailing Address
First Line	:	PO BOX 150282
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-6282
Country	:	US
Telephone Number	:	817-226-2622
Fax Number	:

Provider Business Practice Location Address
First Line	:	2911 MEDLIN DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-2330
Country	:	US
Telephone Number	:	817-226-2622
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DUSTIN QUINN CHRISTENSEN
Credential	:
Telephone Number	:	469-878-0714

Provider Enumeration Date	:	10/28/2008
Last Update Date	:	10/28/2008

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