Healthcare Provider Details

I. General information

NPI: 1225041049
Provider Name (Legal Business Name): CARDIORESPIRATORY HOME SYSTEMS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 W MAIN ST
GUN BARREL CITY TX
75156-5311
US

IV. Provider business mailing address

PO BOX 1840
MABANK TX
75147-1840
US

V. Phone/Fax

Practice location:
  • Phone: 903-887-8005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number0034284
License Number StateTX

VIII. Authorized Official

Name: MR. DENNIS BRYANT MOORE
Title or Position: PRESIDENT
Credential:
Phone: 903-887-8005