=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164823472
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VERTEX HEALTH SOLUTIONS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/07/2014
-----------------------------------------------------
Last Update Date | 09/29/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3941 LEGACY DR SUITE 204 - B103
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75023-8334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-415-1130
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3941 LEGACY DR SUITE 204 - B103
-----------------------------------------------------
City | PLANO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75023-8334
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 972-415-1130
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COO
-----------------------------------------------------
Name | MR. ASHER KURESHY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 972-646-1885
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BC3200X
-----------------------------------------------------
Taxonomy Name | Customized Equipment (DME)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------