Provider Demographics
NPI:1073749024
Name:HEALTHLINE MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:HEALTHLINE MEDICAL EQUIPMENT, INC.
Other - Org Name:HEALTHLINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:DEWAYNE
Authorized Official - Last Name:ANDRUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-691-6100
Mailing Address - Street 1:1502 W UNIVERSITY DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3441
Mailing Address - Country:US
Mailing Address - Phone:972-548-8886
Mailing Address - Fax:972-548-8893
Practice Address - Street 1:1502 W UNIVERSITY DR
Practice Address - Street 2:SUITE 105
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3441
Practice Address - Country:US
Practice Address - Phone:972-548-8886
Practice Address - Fax:972-548-8893
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHLINE MEDICAL EQUIPMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-04
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000070332BC3200X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1093840006Medicare NSC