MEDICARE: ACCURATE MEDICAL EQUIPMENT AND SUPPLY CO., 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)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	015401-0002	OTHER	TX	PACIFICARE PROVIDER
2	8540617	OTHER	TX	AETNA NON HMO PROVIDER
3	0616588	OTHER	TX	AETNA HMO PROVIDER
4	530801	OTHER	TX	BCBS OF TEXAS PROVIDER
5	645665	OTHER	TX	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1821166463
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCURATE MEDICAL EQUIPMENT AND SUPPLY CO., INC.

Provider Business Mailing Address
First Line	:	1214 S MAIN ST
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4803
Country	:	US
Telephone Number	:	817-878-5030
Fax Number	:	817-878-5127

Provider Business Practice Location Address
First Line	:	120 INDUSTRIAL AVE
Second Line	:
City	:	AZLE
State	:	TX
Zip	:	76020-2934
Country	:	US
Telephone Number	:	817-444-0013
Fax Number	:	817-444-0035

Authorized Official
Title or Position	:	CEO
Name	:	MR. SHANNON M REEVES
Credential	:
Telephone Number	:	817-878-5030

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	05/19/2011

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