Provider Demographics
NPI:1356652275
Name:SEGRUF, L.L.C.
Entity Type:Organization
Organization Name:SEGRUF, L.L.C.
Other - Org Name:ELITE DME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:LIZETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:915-256-7161
Mailing Address - Street 1:3465 LEE BLVD STE 233
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-1475
Mailing Address - Country:US
Mailing Address - Phone:915-855-6996
Mailing Address - Fax:915-855-6988
Practice Address - Street 1:3465 LEE BLVD STE 233
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-1475
Practice Address - Country:US
Practice Address - Phone:915-855-6996
Practice Address - Fax:915-855-6988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000329332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition