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General NPI Number Information
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NPI Number | 1760606032
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Entity Type | Organization
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Legal Business Name | LARICO DISCOUNT MEDICAL EQUIPMENT
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 421 STOTTS AVE
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City | EL PASO
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State | TX
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Zip | 79932-2229
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Country | US
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Telephone | 915-875-0890
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Fax | 915-875-0890
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Provider Business Mailing Address
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Address Line | 421 STOTTS AVE
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City | EL PASO
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State | TX
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Zip | 79932-2229
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Country | US
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Telephone | 915-875-0890
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Fax | 915-875-0890
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Authorized Official
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Title or Position | MANAGER
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Name | SOFIA DELOLMO
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Credential | OP
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Telephone | 915-875-0890
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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 | 0031177
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License Number State | TX
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