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General NPI Number Information
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NPI Number | 1700453966
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Entity Type | Organization
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Legal Business Name | RGV MEDICAL SUPPLY LLC
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 03/30/2023
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Provider Practice Location Address
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Address Line | 1333 E JASMINE AVE STE 106
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City | MCALLEN
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State | TX
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Zip | 78501-5708
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Country | US
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Telephone | 956-322-5266
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Fax | 956-322-8056
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Provider Business Mailing Address
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Address Line | 1404 CALLE ESPANA
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City | PHARR
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State | TX
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Zip | 78577-9393
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MICHAEL A HERNANDEZ
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Credential |
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Telephone | 956-310-9629
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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 |
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License Number State |
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