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General NPI Number Information
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NPI Number | 1609059781
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Entity Type | Organization
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Legal Business Name | ADAPTIX MEDICAL SUPPLY, LLC
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Dates
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Enumeration Date | 12/11/2007
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Last Update Date | 12/11/2007
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Provider Practice Location Address
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Address Line | 215 E FREEMAN ST STE 102
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City | DUNCANVILLE
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State | TX
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Zip | 75116-4854
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Country | US
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Telephone | 187-775-4753
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Fax | 480-302-5846
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Provider Business Mailing Address
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Address Line | 215 E FREEMAN ST STE 102
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City | DUNCANVILLE
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State | TX
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Zip | 75116-4854
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Country | US
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Telephone | 187-775-4753
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Fax | 480-302-5846
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Authorized Official
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Title or Position | MANAGER
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Name | RYAN HARPER
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Credential |
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Telephone | 18778547537
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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 | 32034027535
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License Number State | TX
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