MEDICARE: HEALTHLINE 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	0083369	TX
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	0083369	TX
3	332BX2000X	Oxygen Equipment & Supplies (DME)	0083369	TX

General Provider Information

NPI Number	:	1568786580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHLINE MEDICAL EQUIPMENT LLC

Provider Business Mailing Address
First Line	:	555 E NORTH LN STE 5075
Second Line	:
City	:	CONSHOHOCKEN
State	:	PA
Zip	:	19428-2490
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16629 FM 2493
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-7903
Country	:	US
Telephone Number	:	903-526-1070
Fax Number	:	903-526-1071

Authorized Official
Title or Position	:	CCO
Name	:	WENDY RUSSALESI
Credential	:
Telephone Number	:	484-246-9499

Provider Enumeration Date	:	03/19/2010
Last Update Date	:	05/26/2026

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Directions to “HEALTHLINE MEDICAL EQUIPMENT LLC ” Practice Location

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