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General NPI Number Information
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NPI Number | 1710947155
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Entity Type | Organization
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Legal Business Name | CPAP STORE, INC
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Dates
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Enumeration Date | 03/27/2006
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Last Update Date | 09/28/2010
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Provider Practice Location Address
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Address Line | 777 N GROVE RD STE 115
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City | RICHARDSON
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State | TX
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Zip | 75081-2760
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Country | US
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Telephone | 972-480-0500
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Fax | 972-480-0501
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Provider Business Mailing Address
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Address Line | 777 N GROVE RD STE 115
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City | RICHARDSON
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State | TX
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Zip | 75081-2760
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Country | US
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Telephone | 972-480-0500
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Fax | 972-480-0501
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BRETT CARROLL
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Credential | ATP
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Telephone | 972-480-0500
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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 | 0084058
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License Number State | TX
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