Healthcare Provider Details
I. General information
NPI: 1255660585
Provider Name (Legal Business Name): ASSURANT MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/16/2009
Last Update Date: 12/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1114 GERMANY DRIVE
CEDAR HILL TX
75104
US
IV. Provider business mailing address
8035 E. RL THORNTON FRWY STE 420
DALLAS TX
75228
US
V. Phone/Fax
- Phone: 214-753-6721
- Fax: 214-327-5903
- Phone: 214-753-6721
- Fax: 214-327-5903
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ERIC
CHARLES
ROBERTSON
Title or Position: OWNER
Credential: DME
Phone: 214-753-6721