MEDICARE: AMC DURABLE MEDICAL EQUIPMENT 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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1417572108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMC DURABLE MEDICAL EQUIPMENT LLC

Provider Business Mailing Address
First Line	:	3730 N JOSEY LN STE 122
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-2439
Country	:	US
Telephone Number	:	832-620-3800
Fax Number	:

Provider Business Practice Location Address
First Line	:	3730 N JOSEY LN STE 122
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75007-2439
Country	:	US
Telephone Number	:	832-620-3800
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DENNIS CIANCIULLI
Credential	:
Telephone Number	:	832-620-3800

Provider Enumeration Date	:	06/09/2020
Last Update Date	:	06/09/2020

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