=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881784155
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SANTE MEDICAL SUPPLY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2006
-----------------------------------------------------
Last Update Date | 04/01/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1284 PAREDES LINE SUITE 1
-----------------------------------------------------
City | BROWNSVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78521-1715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-542-1988
-----------------------------------------------------
Fax | 956-542-0988
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1284 PAREDES LINE SUITE 1
-----------------------------------------------------
City | BROWNSVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78521-1715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-542-1988
-----------------------------------------------------
Fax | 956-542-0988
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. GRACIELA GUERRA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 956-542-1988
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------