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General NPI Number Information
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NPI Number | 1619047636
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Entity Type | Organization
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Legal Business Name | BACK TO BACK MEDICAL EQUIPMENT DIST LLC
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 03/28/2014
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Provider Practice Location Address
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Address Line | 817 SOUTHMORE AVE STE 100 I
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City | PASADENA
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State | TX
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Zip | 77502-1115
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Country | US
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Telephone | 713-477-0780
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Fax | 855-873-8930
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Provider Business Mailing Address
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Address Line | 817 SOUTHMORE AVE STE 100 I
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City | PASADENA
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State | TX
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Zip | 77502-1115
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Country | US
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Telephone | 713-477-0780
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Fax | 855-873-8930
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Authorized Official
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Title or Position | OWNER CEO
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Name | MS. ASHLEY WASHINGTON
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Credential |
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Telephone | 713-477-0780
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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 | 0075614
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License Number State | TX
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