Healthcare Provider Details

I. General information

NPI: 1427679158
Provider Name (Legal Business Name): TRI-COUNTY DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2020
Last Update Date: 05/06/2020
Certification Date: 05/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 W SESAME DR
HARLINGEN TX
78550-7930
US

IV. Provider business mailing address

613 W SESAME DR
HARLINGEN TX
78550-7930
US

V. Phone/Fax

Practice location:
  • Phone: 956-399-4500
  • Fax: 956-399-4505
Mailing address:
  • Phone: 956-399-4500
  • Fax: 956-399-4505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: HENRY FERNANDEZ
Title or Position: OWNER
Credential:
Phone: 956-399-4500