Provider Demographics
NPI:1083797617
Name:A-MED INC
Entity Type:Organization
Organization Name:A-MED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDI
Authorized Official - Middle Name:M
Authorized Official - Last Name:MANER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-321-7614
Mailing Address - Street 1:19073 I45 SOUTH
Mailing Address - Street 2:#195
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77385-8728
Mailing Address - Country:US
Mailing Address - Phone:936-321-7614
Mailing Address - Fax:936-271-7648
Practice Address - Street 1:19073 I-45 S
Practice Address - Street 2:#195
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77385-8743
Practice Address - Country:US
Practice Address - Phone:936-321-7614
Practice Address - Fax:936-271-7648
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A-MED, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-24
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX015938601Medicaid
TX0449110001Medicare NSC