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General NPI Number Information
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NPI Number | 1417041948
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Entity Type | Organization
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Legal Business Name | MEDINA COUNTY MEDICAL EQUIPMENT CO INC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 1116 E HOUSTON ST STE 102
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City | SAN ANTONIO
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State | TX
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Zip | 78205-2031
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Country | US
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Telephone | 210-949-1660
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Fax | 210-949-0434
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Provider Business Mailing Address
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Address Line | 3750 PRIORITY WAY SOUTH DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-3831
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Country | US
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Telephone | 877-813-0205
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KEVIN GEARHEART
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Credential |
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Telephone | 317-813-4210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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