MEDICARE: DCSTUDIO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1093253403
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DCSTUDIO LLC

Provider Business Mailing Address
First Line	:	2904 E STAN SCHLUETER LOOP STE 502
Second Line	:
City	:	KILLEEN
State	:	TX
Zip	:	76542-4813
Country	:	US
Telephone Number	:	254-299-2911
Fax Number	:

Provider Business Practice Location Address
First Line	:	2904 E STAN SCHLUETER LOOP STE 502
Second Line	:
City	:	KILLEEN
State	:	TX
Zip	:	76542-4813
Country	:	US
Telephone Number	:	254-299-2911
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DEIRDRE CRUELL
Credential	:
Telephone Number	:	254-200-2911

Provider Enumeration Date	:	02/06/2017
Last Update Date	:	02/06/2017

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