MEDICARE: EDDIE'S WHEELCHAIRS, INC.

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		TX

General Provider Information

NPI Number	:	1245200575
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDDIE'S WHEELCHAIRS, INC.

Provider Business Mailing Address
First Line	:	1812 HIGGINS LANE
Second Line	:
City	:	HALTOM CITY
State	:	TX
Zip	:	76111-6715
Country	:	US
Telephone Number	:	817-838-9510
Fax Number	:	817-838-6340

Provider Business Practice Location Address
First Line	:	1812 HIGGINS LN
Second Line	:
City	:	HALTOM CITY
State	:	TX
Zip	:	76111-6715
Country	:	US
Telephone Number	:	817-838-9510
Fax Number	:	817-838-6340

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	GLENDA B SMITH
Credential	:
Telephone Number	:	817-838-9510

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	08/22/2020

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