Healthcare Provider Details

I. General information

NPI: 1942691258
Provider Name (Legal Business Name): PINEWOOD MOBILITY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2015
Last Update Date: 02/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1416 NIX ST
DAINGERFIELD TX
75638-2153
US

IV. Provider business mailing address

1416 NIX ST
DAINGERFIELD TX
75638-2153
US

V. Phone/Fax

Practice location:
  • Phone: 903-645-3917
  • Fax: 903-645-3919
Mailing address:
  • Phone: 903-645-3917
  • Fax: 903-645-3919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DEBBIE FAIR
Title or Position: OFFICER MANAGER
Credential:
Phone: 903-645-3917