MEDICARE: CRAWFORD MEDICAL SUPPLIES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332BN1400X	Nursing Facility Supplies (DME)
2	335G00000X	Medical Foods Supplier
3	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1881961191
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRAWFORD MEDICAL SUPPLIES LLC

Provider Business Mailing Address
First Line	:	2608 N MAIN AVE
Second Line	:	SUITE 2
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-2919
Country	:	US
Telephone Number	:	210-225-7400
Fax Number	:	210-569-6266

Provider Business Practice Location Address
First Line	:	2608 N MAIN AVE
Second Line	:	SUITE 2
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-2919
Country	:	US
Telephone Number	:	210-225-7400
Fax Number	:	210-569-6266

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. PREM KALIDINDI
Credential	:
Telephone Number	:	917-769-8014

Provider Enumeration Date	:	11/30/2011
Last Update Date	:	04/12/2013

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Directions to “CRAWFORD MEDICAL SUPPLIES LLC ” Practice Location

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