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General NPI Number Information
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NPI Number | 1750302329
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Entity Type | Organization
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Legal Business Name | CROSSROADS MEDICAL EQUIPMENT & SUPPLY, INC.
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 10/22/2007
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Provider Practice Location Address
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Address Line | 1514 S 77 SUNSHINESTRIP SUITE #13
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City | HARLINGEN
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State | TX
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Zip | 78550-7208
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Country | US
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Telephone | 956-444-0555
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Fax | 956-444-0702
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Provider Business Mailing Address
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Address Line | 1514 S 77 SUNSHINESTRIP SUITE #13
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City | HARLINGEN
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State | TX
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Zip | 78550-7208
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Country | US
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Telephone | 956-444-0555
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Fax | 956-444-0702
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Authorized Official
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Title or Position | OWNER ADMINISTRATOR
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Name | MRS. LISA ANN WELLS
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Credential |
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Telephone | 956-444-0555
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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 | 0061347
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License Number State | TX
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