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General NPI Number Information
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NPI Number | 1881556637
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Entity Type | Organization
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Legal Business Name | LONE STAR DME SUPPLIER LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 195 S HIGHWAY 89
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City | NORTH SALT LAKE
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State | UT
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Zip | 84054-2543
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Country | US
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Telephone | 307-289-2158
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Fax |
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Provider Business Mailing Address
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Address Line | 195 S HIGHWAY 89
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City | NORTH SALT LAKE
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State | UT
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Zip | 84054-2543
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ZAFAR TARIQ
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Credential |
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Telephone | 307-289-2158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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