Healthcare Provider Details

I. General information

NPI: 1013707348
Provider Name (Legal Business Name): ENTRAMED, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 PROVIDENCE DR STE B04
ANCHORAGE AK
99508-4690
US

IV. Provider business mailing address

27905 COMMERCIAL PARK RD STE 240
TOMBALL TX
77375-6580
US

V. Phone/Fax

Practice location:
  • Phone: 907-290-8060
  • Fax: 907-290-8061
Mailing address:
  • Phone: 713-955-2123
  • Fax: 281-742-2589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: JEREMY CRABB
Title or Position: CO-CEO
Credential:
Phone: 713-955-2123