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General NPI Number Information
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NPI Number | 1790008845
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Entity Type | Organization
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Legal Business Name | ABC HOME MEDICAL SUPPLY
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 03/03/2010
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Provider Practice Location Address
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Address Line | 12630 E NORTHWEST HWY SUITE 303
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City | DALLAS
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State | TX
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Zip | 75228-8025
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Country | US
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Telephone | 972-279-9090
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Fax | 972-270-7282
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Provider Business Mailing Address
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Address Line | 525 N TRYON ST SUITE 1600
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City | CHARLOTTE
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State | NC
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Zip | 28202-0200
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Country | US
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Telephone | 866-897-8588
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Fax | 972-270-7282
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Authorized Official
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Title or Position | PRES
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Name | TRICIA LABAR
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Credential |
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Telephone | 866-897-8588
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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 | 0069038
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License Number State | TX
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