Provider Demographics
NPI:1407159817
Name:URS SUB I, LLC
Entity Type:Organization
Organization Name:URS SUB I, LLC
Other - Org Name:URS MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:R
Authorized Official - Last Name:HAGELSTEIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:254-751-1556
Mailing Address - Street 1:4830 LAKEWOOD DR STE 1
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-2966
Mailing Address - Country:US
Mailing Address - Phone:254-751-1556
Mailing Address - Fax:254-751-1960
Practice Address - Street 1:4830 LAKEWOOD DR STE 1
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-2966
Practice Address - Country:US
Practice Address - Phone:254-751-1556
Practice Address - Fax:254-751-1960
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:URS SUB, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-08
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000532332B00000X, 332BP3500X, 332B00000X, 332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000987OtherDEVICE DISTRIBUTOR