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General NPI Number Information
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NPI Number | 1508882317
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Entity Type | Organization
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Legal Business Name | BROSCO INTERNATIONAL INC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 05/06/2019
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Provider Practice Location Address
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Address Line | 925 N BRYAN BELT LINE RD STE 105
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City | MESQUITE
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State | TX
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Zip | 75149-2541
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Country | US
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Telephone | 972-329-5555
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Fax | 972-329-0008
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Provider Business Mailing Address
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Address Line | 925 N BRYAN BELT LINE RD STE 105
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City | MESQUITE
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State | TX
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Zip | 75149-2541
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Country | US
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Telephone | 972-329-5555
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Fax | 972-692-8245
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOHN T MANIYATT
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Credential |
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Telephone | 972-329-5555
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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 | 0038660
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License Number State | TX
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