MEDICARE: ALAMO CITY DURABLE MEDICAL EQUIPMENT, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BX2000X	Oxygen Equipment & Supplies (DME)
3	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1912336611
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALAMO CITY DURABLE MEDICAL EQUIPMENT, LLC

Provider Business Mailing Address
First Line	:	10643 SENTINEL ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-3811
Country	:	US
Telephone Number	:	210-829-5900
Fax Number	:	210-829-3760

Provider Business Practice Location Address
First Line	:	10643 SENTINEL ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78217-3811
Country	:	US
Telephone Number	:	210-829-5900
Fax Number	:	210-829-3760

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	PATRICIA LYNN HOLSTEAD
Credential	:
Telephone Number	:	210-737-2444

Provider Enumeration Date	:	11/04/2013
Last Update Date	:	05/12/2020

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