MEDICARE: THME, 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	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1740468438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THME, INC.

Provider Business Mailing Address
First Line	:	4801 LAKESHORE CT
Second Line	:
City	:	COLLEYVILLE
State	:	TX
Zip	:	76034-2828
Country	:	US
Telephone Number	:	972-206-0111
Fax Number	:	972-602-0391

Provider Business Practice Location Address
First Line	:	2100 N HWY 360
Second Line	:	1704
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75050-1009
Country	:	US
Telephone Number	:	972-206-0111
Fax Number	:	972-602-0391

Authorized Official
Title or Position	:	CEO
Name	:	MRS. ALLAN RAY JACKSON
Credential	:	RRT
Telephone Number	:	972-206-0111

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	02/05/2008

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