Healthcare Provider Details

I. General information

NPI: 1073755047
Provider Name (Legal Business Name): MEDSTRIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 03/28/2022
Certification Date: 03/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 WHITING RD
BELLS TX
75414-2770
US

IV. Provider business mailing address

1241 WHITING RD
BELLS TX
75414-2770
US

V. Phone/Fax

Practice location:
  • Phone: 888-697-2488
  • Fax: 888-573-7232
Mailing address:
  • Phone: 888-697-2488
  • Fax: 888-573-7232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number01513
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1000761
License Number StateTX

VIII. Authorized Official

Name: JENNIFER M WOODY
Title or Position: MANAGING MEMBER
Credential:
Phone: 903-771-0066