=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801114715
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FINCK'S HOME MEDICAL EQUIPMENT PRO'S
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/17/2010
-----------------------------------------------------
Last Update Date | 08/09/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3333 S COULTER ST STE C8
-----------------------------------------------------
City | AMARILLO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79106-2727
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-358-2940
-----------------------------------------------------
Fax | 806-358-2945
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3333 S COULTER ST STE C8
-----------------------------------------------------
City | AMARILLO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79106-2727
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-358-2940
-----------------------------------------------------
Fax | 806-358-2945
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO/OWNER
-----------------------------------------------------
Name | DEBORAH K FINCK
-----------------------------------------------------
Credential | BSW
-----------------------------------------------------
Telephone | 806-358-2940
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332BX2000X
-----------------------------------------------------
Taxonomy Name | Oxygen Equipment & Supplies (DME)
-----------------------------------------------------
License Number | 1000340
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------