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General NPI Number Information
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NPI Number | 1720047095
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Entity Type | Organization
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Legal Business Name | DURABLE MEDICAL EQUIPMENT, INC
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 10/09/2009
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Provider Practice Location Address
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Address Line | 100 MOOTY BRIDGE RD
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City | LAGRANGE
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State | GA
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Zip | 30240-1806
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Country | US
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Telephone | 706-882-2661
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Fax | 706-882-2251
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Provider Business Mailing Address
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Address Line | 100 MOOTY BRIDGE RD
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City | LAGRANGE
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State | GA
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Zip | 30240-1806
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Country | US
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Telephone | 706-882-2661
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Fax | 706-882-2251
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | THOMAS E BECKHAM
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Credential | R.PH.
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Telephone | 706-882-2661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | C19509
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License Number State |
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Taxonomy #2
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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 | GA
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Taxonomy #3
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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