=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609466267
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LYNX AND ASSOCIATE, LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/19/2021
-----------------------------------------------------
Last Update Date | 01/25/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2591 DALLAS PKWY STE 300
-----------------------------------------------------
City | FRISCO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75034-8563
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-405-9910
-----------------------------------------------------
Fax | 877-617-8003
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6201 CHESHIRE ST
-----------------------------------------------------
City | AUBREY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76227-2385
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-292-9933
-----------------------------------------------------
Fax | 877-617-8003
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRESIDENT
-----------------------------------------------------
Name | MR. JEFFREY JEFFREY BUNDO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 877-405-9910
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------