Provider Demographics
NPI:1093353880
Name:BEAN FAMILY ENTERPRISES
Entity Type:Organization
Organization Name:BEAN FAMILY ENTERPRISES
Other - Org Name:MAIN STREET MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:RHEA
Authorized Official - Last Name:BEAN
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:254-939-7171
Mailing Address - Street 1:PO BOX 1417
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-5417
Mailing Address - Country:US
Mailing Address - Phone:254-831-3093
Mailing Address - Fax:
Practice Address - Street 1:1225 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-1901
Practice Address - Country:US
Practice Address - Phone:254-831-3093
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEAN FAMILY ENTERPRISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-12
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies