MEDICARE: PECO ENTERPRISES 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326068164
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PECO ENTERPRISES INC

Provider Business Mailing Address
First Line	:	1910 SILVER ST
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-6645
Country	:	US
Telephone Number	:	972-494-3334
Fax Number	:	972-487-9663

Provider Business Practice Location Address
First Line	:	1910 SILVER ST
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-6645
Country	:	US
Telephone Number	:	972-494-3334
Fax Number	:	972-487-9663

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TIMOTHY DAVID WILLIAMS
Credential	:
Telephone Number	:	972-494-3334

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/10/2019

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Directions to “PECO ENTERPRISES INC ” Practice Location

Language	Start Address	Practice Location

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