Provider Demographics
NPI:1316181654
Name:ZOOM MEDICAL PRODUCTS INC.4275949
Entity Type:Organization
Organization Name:ZOOM MEDICAL PRODUCTS INC.4275949
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:QUINN
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-878-0714
Mailing Address - Street 1:PO BOX 153101
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-9101
Mailing Address - Country:US
Mailing Address - Phone:214-227-2334
Mailing Address - Fax:214-227-2315
Practice Address - Street 1:3200 S CARRIER PKWY STE 201
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-6053
Practice Address - Country:US
Practice Address - Phone:214-227-2334
Practice Address - Fax:214-227-2315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0109743332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0109743OtherTEXAS STATE MEDICAL DEVICE LICENSE