Provider Demographics
NPI:1003383019
Name:SAN JOSE DME LLC
Entity Type:Organization
Organization Name:SAN JOSE DME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-801-2065
Mailing Address - Street 1:1005 E 10TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-5133
Mailing Address - Country:US
Mailing Address - Phone:956-801-2065
Mailing Address - Fax:
Practice Address - Street 1:1005 E 10TH ST STE B
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-5133
Practice Address - Country:US
Practice Address - Phone:956-801-2065
Practice Address - Fax:956-435-9253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-28
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies