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General NPI Number Information
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NPI Number | 1740367531
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Entity Type | Organization
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Legal Business Name | SUPPORT MEDICAL COMPANY
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4821 34TH ST
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City | LUBBOCK
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State | TX
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Zip | 79410-2421
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Country | US
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Telephone | 806-792-9770
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Fax | 806-792-9774
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Provider Business Mailing Address
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Address Line | 4821 34TH ST
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City | LUBBOCK
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State | TX
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Zip | 79410-2421
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Country | US
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Telephone | 806-792-9770
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Fax | 806-792-9774
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Authorized Official
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Title or Position | PRES./CEO
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Name | MR. SHELBY STAGGS
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Credential |
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Telephone | 806-792-9770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number | NOT APPLICABLE
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License Number State |
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