MEDICARE: CLOSE TO YOU, 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	332BC3200X	Customized Equipment (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies	0039285	TX

General Provider Information

NPI Number	:	1336245513
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLOSE TO YOU, INC.

Provider Business Mailing Address
First Line	:	11661 PRESTON RD STE 154
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-7011
Country	:	US
Telephone Number	:	214-692-8893
Fax Number	:	214-692-8945

Provider Business Practice Location Address
First Line	:	11661 PRESTON RD STE 154
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-7011
Country	:	US
Telephone Number	:	214-692-8893
Fax Number	:	214-692-8945

Authorized Official
Title or Position	:	PRESIDENT OWNER
Name	:	MRS. SUSAN MCMAHAN
Credential	:
Telephone Number	:	214-692-8893

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	07/07/2009

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Directions to “CLOSE TO YOU, INC. ” Practice Location

Language	Start Address	Practice Location

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