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General NPI Number Information
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NPI Number | 1225248586
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Entity Type | Organization
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Legal Business Name | PREMIER DME
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 12/05/2010
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Provider Practice Location Address
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Address Line | 508 W CANTON RD STE B
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City | EDINBURG
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State | TX
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Zip | 78539-6136
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Country | US
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Telephone | 956-380-6030
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Fax | 956-383-2212
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Provider Business Mailing Address
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Address Line | 508 W CANTON RD STE B
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City | EDINBURG
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State | TX
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Zip | 78539-6136
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Country | US
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Telephone | 956-380-6030
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Fax | 956-383-2212
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LEONEL GUERRERO
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Credential |
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Telephone | 956-380-6030
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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 | 0088046
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License Number State | TX
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