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General NPI Number Information
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NPI Number | 1932172715
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Entity Type | Organization
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Legal Business Name | AMERICAN HOME MEDICAL SUPPLY LLC
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 08/20/2008
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Provider Practice Location Address
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Address Line | 5918 MCPHERSON RD STE 4
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City | LAREDO
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State | TX
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Zip | 78041-6159
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Country | US
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Telephone | 956-712-2273
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Fax | 956-712-3766
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Provider Business Mailing Address
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Address Line | 1011 E 7TH ST
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City | DEL RIO
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State | TX
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Zip | 78840-4162
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Country | US
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Telephone | 830-768-1818
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Fax | 830-778-8618
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | KENNETH EDWARD WIESE
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Credential |
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Telephone | 830-775-4060
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number | 0082282
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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