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General NPI Number Information
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NPI Number | 1063099331
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Entity Type | Organization
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Legal Business Name | BIG HORN DME LLC
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 7600 CHEVY CHASE DR STE 300
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City | AUSTIN
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State | TX
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Zip | 78752-1599
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Country | US
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Telephone | 603-505-5650
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Fax |
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Provider Business Mailing Address
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Address Line | 300 BRICKSTONE SQ STE 201
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City | ANDOVER
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State | MA
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Zip | 01810-1497
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Country | US
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Telephone | 603-505-5650
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Fax |
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Authorized Official
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Title or Position | VP OPERATIONS
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Name | MR. JOHN ECKERT
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Credential |
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Telephone | 603-505-5650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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