=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649663360
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | H.O.P.E- HOME OUTDOOR PRODUCT ESSENTIALS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2015
-----------------------------------------------------
Last Update Date | 03/05/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 512 N HAMPTON RD # 302
-----------------------------------------------------
City | DESOTO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75115-4920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-290-3790
-----------------------------------------------------
Fax | 866-290-3790
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 512 N HAMPTON RD # 302
-----------------------------------------------------
City | DESOTO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75115-4920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 866-290-3790
-----------------------------------------------------
Fax | 866-290-3790
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER MANAGER
-----------------------------------------------------
Name | MRS. NELDA JOYCE GRIGGS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 866-290-3790
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------