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General NPI Number Information
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NPI Number | 1992768717
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Entity Type | Organization
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Legal Business Name | LONG TERM MEDICAL EQUIPMENT AND SUPPLIES
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 08/28/2009
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Provider Practice Location Address
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Address Line | 111 W ANDERSON LN D 206
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City | AUSTIN
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State | TX
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Zip | 78752-1132
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Country | US
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Telephone | 512-374-9080
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Fax | 512-374-0053
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Provider Business Mailing Address
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Address Line | 111 W ANDERSON LN D 206
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City | AUSTIN
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State | TX
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Zip | 78752-1132
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Country | US
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Telephone | 512-374-9080
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Fax | 512-374-0053
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Authorized Official
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Title or Position | OWNER
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Name | EMMANUEL IROANYA
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Credential |
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Telephone | 512-374-9080
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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 | 0070596
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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 | 0070596
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License Number State | TX
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