MEDICARE: EQUIPPED 2 CARE 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	1001196	TX

General Provider Information

NPI Number	:	1205269628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EQUIPPED 2 CARE LLC

Provider Business Mailing Address
First Line	:	1025 E MAIN ST
Second Line	:	STE 102
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-2495
Country	:	US
Telephone Number	:	281-724-0124
Fax Number	:

Provider Business Practice Location Address
First Line	:	1025 E MAIN ST
Second Line	:	STE 102
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-2495
Country	:	US
Telephone Number	:	281-724-0124
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	JAMIE HINSON
Credential	:
Telephone Number	:	281-724-0124

Provider Enumeration Date	:	08/21/2013
Last Update Date	:	10/29/2014

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