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General NPI Number Information
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NPI Number | 1023385879
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Entity Type | Organization
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Legal Business Name | MEDWAY MEDICAL EQUIPMENT III LLC
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Dates
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Enumeration Date | 11/22/2011
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Last Update Date | 07/18/2018
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Provider Practice Location Address
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Address Line | 3448 W LOOP 289
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City | LUBBOCK
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State | TX
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Zip | 79407
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Country | US
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Telephone | 806-797-8888
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Fax | 806-797-8889
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Provider Business Mailing Address
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Address Line | 3448 W LOOP 289
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City | LUBBOCK
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State | TX
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Zip | 79407-3745
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Country | US
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Telephone | 806-797-8888
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Fax | 806-797-8889
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL DON TROTTER
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Credential |
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Telephone | 806-797-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 1000659
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License Number State | TX
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