=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588623383
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RIO DME LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/21/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4201 S SHARY RD 104-B
-----------------------------------------------------
City | MISSION
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78572-1578
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-424-7137
-----------------------------------------------------
Fax | 956-424-7167
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4201 S SHARY RD 104-B
-----------------------------------------------------
City | MISSION
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78572-1578
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-424-7137
-----------------------------------------------------
Fax | 956-424-7167
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OPERATIONS MANAGER
-----------------------------------------------------
Name | JANIE OLIVARES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 956-424-7137
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------