Provider Demographics
NPI:1386683779
Name:PARIS MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:PARIS MEDICAL SUPPLY, INC.
Other - Org Name:PRO CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:G
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-785-6615
Mailing Address - Street 1:2502 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75426-3319
Mailing Address - Country:US
Mailing Address - Phone:903-427-5154
Mailing Address - Fax:903-427-5855
Practice Address - Street 1:2502 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75426-3319
Practice Address - Country:US
Practice Address - Phone:903-427-5154
Practice Address - Fax:903-427-5855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0035544332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX011040501Medicaid
TX017019301Medicaid
TX011040501Medicaid