Provider Demographics
NPI:1306034459
Name:SPACE CENTER MEDICAL EQUIPMENT, INC
Entity Type:Organization
Organization Name:SPACE CENTER MEDICAL EQUIPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:281-990-9500
Mailing Address - Street 1:17000 EL CAMINO REAL STE 201
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2633
Mailing Address - Country:US
Mailing Address - Phone:281-990-9500
Mailing Address - Fax:
Practice Address - Street 1:17000 EL CAMINO REAL STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2633
Practice Address - Country:US
Practice Address - Phone:281-990-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2007-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies