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General NPI Number Information
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NPI Number | 1457843666
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Entity Type | Organization
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Legal Business Name | ACCUMED MEDICAL SUPPLY, LLC
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Dates
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Enumeration Date | 06/04/2018
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Last Update Date | 06/04/2018
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Provider Practice Location Address
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Address Line | 6923 W LOOP 1604 N SUITE 208
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City | SAN ANTONIO
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State | TX
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Zip | 78254
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Country | US
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Telephone | 210-507-2065
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Fax |
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Provider Business Mailing Address
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Address Line | 6923 WEST LOOP 1604 NORTH SUITE 208
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City | SAN ANTONIO
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State | TX
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Zip | 78254
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Country | US
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Telephone | 210-507-2065
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MARK DANIEL MAURICIO
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Credential |
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Telephone | 210-587-5936
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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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