MEDICARE: MEDIGY 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	0075939	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881630762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDIGY LLC

Provider Business Mailing Address
First Line	:	1822 N SYLVANIA AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76111-2755
Country	:	US
Telephone Number	:	817-379-6334
Fax Number	:	817-379-6335

Provider Business Practice Location Address
First Line	:	1822 N SYLVANIA AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76111-2755
Country	:	US
Telephone Number	:	817-379-6334
Fax Number	:	817-379-6335

Authorized Official
Title or Position	:	CEO
Name	:	KEN HARDING
Credential	:
Telephone Number	:	817-379-6334

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	01/26/2015

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Directions to “MEDIGY LLC ” Practice Location

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