Healthcare Provider Details

I. General information

NPI: 1912933664
Provider Name (Legal Business Name): REDI-QUIP MEDICAL EQUIPMENT & SUPPLIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 08/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16820 BARKER SPRINGS RD SUITE E500
HOUSTON TX
77084-5040
US

IV. Provider business mailing address

PO BOX 218418
HOUSTON TX
77218-8418
US

V. Phone/Fax

Practice location:
  • Phone: 281-492-2799
  • Fax: 281-492-7479
Mailing address:
  • Phone: 281-492-2799
  • Fax: 281-492-7479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES WILLIAM PETERSON III
Title or Position: PRESIDENT
Credential:
Phone: 281-492-2799