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General NPI Number Information
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NPI Number | 1538158662
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Entity Type | Organization
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Legal Business Name | GREENVILLE HOME TOWN MEDICAL EQUIPMENT INC
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2701 WASHINGTON ST
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City | GREENVILLE
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State | TX
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Zip | 75401-4113
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Country | US
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Telephone | 903-455-4788
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Fax | 903-455-4695
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Provider Business Mailing Address
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Address Line | 2701 WASHINGTON ST
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City | GREENVILLE
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State | TX
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Zip | 75401-4113
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Country | US
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Telephone | 903-455-4788
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Fax | 903-455-4695
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HAROLD R CLAYTON JR.
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Credential | RPH
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Telephone | 903-455-4788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | 0010866
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License Number State | TX
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