MEDICARE: REXCO HOME MEDICAL & EQUIPMENT

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	:	1326104381
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REXCO HOME MEDICAL & EQUIPMENT

Provider Business Mailing Address
First Line	:	103 W COMMERCE ST
Second Line	:
City	:	ALTUS
State	:	OK
Zip	:	73521-3807
Country	:	US
Telephone Number	:	580-480-1055
Fax Number	:	580-480-1077

Provider Business Practice Location Address
First Line	:	103 W COMMERCE ST
Second Line	:
City	:	ALTUS
State	:	OK
Zip	:	73521-3807
Country	:	US
Telephone Number	:	580-480-1055
Fax Number	:	580-480-1077

Authorized Official
Title or Position	:	OWNER
Name	:	MR. STANLEY BRUE RESTER
Credential	:
Telephone Number	:	580-726-5244

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	03/21/2008

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