Provider Demographics
NPI:1093932774
Name:OCEAN VIEW DURABLE MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:OCEAN VIEW DURABLE MEDICAL EQUIPMENT, INC.
Other - Org Name:OCEAN VIEW DURABLE MEDICAL EQUIPMENT, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:I
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-991-9200
Mailing Address - Street 1:4639 CORONA DR
Mailing Address - Street 2:SUITE 36
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5401
Mailing Address - Country:US
Mailing Address - Phone:361-991-9200
Mailing Address - Fax:361-991-9201
Practice Address - Street 1:4639 CORONA DR
Practice Address - Street 2:SUITE 36
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5401
Practice Address - Country:US
Practice Address - Phone:361-991-9200
Practice Address - Fax:361-991-9201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0097089332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX191620702Medicaid
TX191620701Medicaid
TX5946280001Medicare NSC