Healthcare Provider Details

I. General information

NPI: 1699770891
Provider Name (Legal Business Name): SCOOTERS WHEELCHAIRS TOO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1712 W MAIN ST
GUN BARREL CITY TX
75156-4398
US

IV. Provider business mailing address

1712 W MAIN ST
GUN BARREL CITY TX
75156-4398
US

V. Phone/Fax

Practice location:
  • Phone: 903-887-2221
  • Fax: 903-887-2228
Mailing address:
  • Phone: 903-887-2221
  • Fax: 903-887-2228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1--9
License Number StateTX

VIII. Authorized Official

Name: MR. BYRON K GREEN
Title or Position: OWNER
Credential:
Phone: 903-887-2221