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)	0058191	TX

General Provider Information

NPI Number	:	1891914438
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 STATE HIGHWAY 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	:	PRESIDENT OWNER
Name	:	MRS. SHARON RUTH JACKSON
Credential	:
Telephone Number	:	972-206-0111

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	11/05/2007

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