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General NPI Number Information
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NPI Number | 1952160525
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Entity Type | Organization
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Legal Business Name | FOM INDUSTRIES, LLC
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Dates
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Enumeration Date | 03/18/2024
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 2064 OEDIPUS DR
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City | SAN ANTONIO
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State | TX
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Zip | 78245-7700
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Country | US
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Telephone | 210-788-6948
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Fax |
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Provider Business Mailing Address
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Address Line | 2064 OEDIPUS DR
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City | SAN ANTONIO
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State | TX
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Zip | 78245-7700
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Country | US
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Telephone | 210-788-6948
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JOSE F GONZALEZ
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Credential |
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Telephone | 978-245-6699
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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