Provider Demographics
NPI:1295827780
Name:DEGC ENTERPRISES (U.S.), INC.
Entity Type:Organization
Organization Name:DEGC ENTERPRISES (U.S.), INC.
Other - Org Name:CCS MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFMEISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-628-2100
Mailing Address - Street 1:3030 LBJ FWY STE 1525
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7758
Mailing Address - Country:US
Mailing Address - Phone:972-628-2100
Mailing Address - Fax:
Practice Address - Street 1:14255 49TH ST N STE 301
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33762-2813
Practice Address - Country:US
Practice Address - Phone:888-308-8882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEGC ENTERPRISES (U.S.), INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-29
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
FLPH16544333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1295827780Medicaid
ND1452096Medicaid
OK200485810BMedicaid
LA2410695Medicaid
OR270170Medicaid
MI4661820Medicaid
MS00475041Medicaid
AZ095938Medicaid
MO1295827780Medicaid
MD418557900Medicaid
PA0071099160002Medicaid
MA110120704AMedicaid
CO21134880Medicaid
MD418555200Medicaid
TN4582026Medicaid
HI554461-01Medicaid
NM0000S2341Medicaid
GA003115482AMedicaid
CT008051699Medicaid
DC019655038Medicaid
IL1295827780Medicaid
TX166539001Medicaid
NE100263167-00Medicaid
VT1021718Medicaid
ME1295827780Medicaid
AR133815741Medicaid
DE200135239Medicaid
KY7100128580Medicaid
FL031053101Medicaid
UT1295827780Medicaid
IN200170920AMedicaid
OK200485810AMedicaid
KS200641630AMedicaid
KS200641680AMedicaid
SC7F6544Medicaid
ID80856330Medicaid
GA000697903AMedicaid
GA000697903CMedicaid
AL009974245Medicaid
AK1584294Medicaid
OH2620435Medicaid
NH3088307Medicaid
KY7100071860Medicaid
IA0206057Medicaid
NJ0249777Medicaid
FL031053100Medicaid
NY03214239Medicaid
CA1295827780Medicaid
WA2008599Medicaid
WI81811200Medicaid