Provider Demographics
NPI:1134286271
Name:MEDCAST, INC
Entity Type:Organization
Organization Name:MEDCAST, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:915-781-7070
Mailing Address - Street 1:7501 LOCKHEED DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-2458
Mailing Address - Country:US
Mailing Address - Phone:915-781-7070
Mailing Address - Fax:915-781-7089
Practice Address - Street 1:7501 LOCKHEED DR
Practice Address - Street 2:SUITE B
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-2458
Practice Address - Country:US
Practice Address - Phone:915-781-7070
Practice Address - Fax:915-781-7089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14550332BP3500X, 3336H0001X
TX0052467332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Not Answered3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0444850001Medicare ID - Type Unspecified