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NPI Code Detail

MEDICARE: AMITY MED LLC

MEDICARE: AMITY MED 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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1417329079
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMITY MED LLC
Provider Business Mailing Address
First Line : 10685B HAZELHURST DR
Second Line : 17926
City : HOUSTON
State : TX
Zip : 77043-3238
Country : US
Telephone Number : 832-478-7383
Fax Number :
Provider Business Practice Location Address
First Line : 10685B HAZELHURST DR
Second Line : 17926
City : HOUSTON
State : TX
Zip : 77043-3238
Country : US
Telephone Number : 832-478-7383
Fax Number :
Authorized Official
Title or Position : MEMBER
Name : MR. JASON RIDGEL
Credential :
Telephone Number : 832-478-7383
Provider Enumeration Date : 10/22/2015
Last Update Date : 10/22/2015

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Directions to “AMITY MED LLC ” Practice Location

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