Provider Demographics
NPI:1093047730
Name:AMIGO DME LLC
Entity Type:Organization
Organization Name:AMIGO DME LLC
Other - Org Name:AMIGO MEDICAL EQUIPMENT & SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:G
Authorized Official - Last Name:REYNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-683-7012
Mailing Address - Street 1:PO BOX 720375
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-0375
Mailing Address - Country:US
Mailing Address - Phone:956-683-7012
Mailing Address - Fax:956-683-7010
Practice Address - Street 1:1205 W PECAN BLVD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4349
Practice Address - Country:US
Practice Address - Phone:956-683-7012
Practice Address - Fax:956-683-7010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-05
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000294332B00000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies