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General NPI Number Information
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NPI Number | 1205537669
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Entity Type | Organization
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Legal Business Name | NUESTRA COSECHA DME, LLC
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Dates
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Enumeration Date | 03/13/2023
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 18012 SAGO PALM DR STE 2
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City | PENITAS
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State | TX
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Zip | 78576-7392
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Country | US
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Telephone | 956-599-9873
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Fax | 956-599-9874
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Provider Business Mailing Address
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Address Line | 1625 CAMINO REAL BLVD
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City | PENITAS
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State | TX
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Zip | 78576-2077
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Country | US
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Telephone | 956-208-0623
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Fax | 956-599-9874
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Authorized Official
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Title or Position | MEMBER
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Name | CYNTHIA PALOMO
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Credential |
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Telephone | 956-599-9873
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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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