MEDICARE: PREMIUM DME SERVICES 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	332B00000X	Durable Medical Equipment & Medical Supplies	0098701	TX

General Provider Information

NPI Number	:	1992999379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREMIUM DME SERVICES INC

Provider Business Mailing Address
First Line	:	6006 BELLAIRE BLVD
Second Line	:	SUITE 107
City	:	HOUSTON
State	:	TX
Zip	:	77081-5404
Country	:	US
Telephone Number	:	713-662-0508
Fax Number	:	866-587-4573

Provider Business Practice Location Address
First Line	:	6006 BELLAIRE BLVD
Second Line	:	SUITE 107
City	:	HOUSTON
State	:	TX
Zip	:	77081-5404
Country	:	US
Telephone Number	:	713-662-0508
Fax Number	:	866-587-4573

Authorized Official
Title or Position	:	CEO
Name	:	MR. FRANCIS A EDUOK
Credential	:
Telephone Number	:	713-662-0508

Provider Enumeration Date	:	08/29/2007
Last Update Date	:	04/16/2008

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