Provider Demographics
NPI:1144229071
Name:CARSON H, INC.
Entity Type:Organization
Organization Name:CARSON H, INC.
Other - Org Name:CARSON MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE- PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:B
Authorized Official - Last Name:HEACKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-833-5900
Mailing Address - Street 1:2515 CALDER ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1915
Mailing Address - Country:US
Mailing Address - Phone:409-833-5900
Mailing Address - Fax:409-833-2509
Practice Address - Street 1:2515 CALDER ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1915
Practice Address - Country:US
Practice Address - Phone:409-833-5900
Practice Address - Fax:409-833-2509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX0011006332B00000X
332BC3200X, 332BP3500X
TX0066497332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4027030001Medicare NSC