Provider Demographics
NPI:1417926106
Name:AXIS MEDICAL EQUIPMENT & SUPPLY, LLC
Entity Type:Organization
Organization Name:AXIS MEDICAL EQUIPMENT & SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-889-2947
Mailing Address - Street 1:3214 BELT LINE RD STE 426
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-2326
Mailing Address - Country:US
Mailing Address - Phone:972-889-2947
Mailing Address - Fax:972-767-4762
Practice Address - Street 1:3214 BELT LINE RD STE 426
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-2326
Practice Address - Country:US
Practice Address - Phone:972-889-2947
Practice Address - Fax:972-767-4762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159362601Medicaid
TX531726OtherBLUE CROSS BLUE SHIELD
TX159362601Medicaid
TX1417926106Medicare PIN