=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619099777
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MEDME SERVICES CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2007
-----------------------------------------------------
Last Update Date | 08/07/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4110 RIO BRAVO ST SUITE 110
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79902-1027
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-313-9922
-----------------------------------------------------
Fax | 915-313-9955
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 920173
-----------------------------------------------------
City | EL PASO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79902-0004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 915-313-9922
-----------------------------------------------------
Fax | 915-313-9955
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. SANDRA L JUAREZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 915-313-9922
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 0085310
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------