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General NPI Number Information
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NPI Number | 1174577621
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Entity Type | Organization
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Legal Business Name | FIFTY50 FOODS LP
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 08/22/2008
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Provider Practice Location Address
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Address Line | 1420 VALWOOD PKWY SUITE 205
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City | CARROLLTON
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State | TX
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Zip | 75006-8312
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Country | US
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Telephone | 972-243-2727
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Fax | 972-243-3111
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Provider Business Mailing Address
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Address Line | 1420 VALWOOD PKWY SUITE 205
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City | CARROLLTON
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State | TX
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Zip | 75006-8312
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Country | US
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Telephone | 972-243-2727
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Fax | 972-243-3111
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | GEORGE R LYNCH
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Credential |
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Telephone | 972-243-2727
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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 | 0086459
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License Number State | TX
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