Provider Demographics
NPI:1093034852
Name:CWO LLC
Entity Type:Organization
Organization Name:CWO LLC
Other - Org Name:PINNELL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER/COMPLIANCE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:LATONA
Authorized Official - Middle Name:GAY
Authorized Official - Last Name:BELT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-288-9490
Mailing Address - Street 1:3320 OLTON RD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-6630
Mailing Address - Country:US
Mailing Address - Phone:806-288-9490
Mailing Address - Fax:806-288-9471
Practice Address - Street 1:3320 OLTON RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-6630
Practice Address - Country:US
Practice Address - Phone:806-288-9490
Practice Address - Fax:806-288-9471
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-19
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3-20342-1768-0332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6442110001Medicare NSC