Provider Demographics
NPI:1437227790
Name:NATIONAL MEDICAL ENTERPRISE
Entity Type:Organization
Organization Name:NATIONAL MEDICAL ENTERPRISE
Other - Org Name:NATIONAL MEDICAL ENTERPRISE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KERWIN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:I
Authorized Official - Credentials:O&P FITTER
Authorized Official - Phone:214-760-3574
Mailing Address - Street 1:500 W UNIVERSITY DR
Mailing Address - Street 2:STE.112
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-4823
Mailing Address - Country:US
Mailing Address - Phone:214-760-3574
Mailing Address - Fax:214-383-2022
Practice Address - Street 1:500 W UNIVERSITY DR
Practice Address - Street 2:STE.112
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-4823
Practice Address - Country:US
Practice Address - Phone:214-760-3574
Practice Address - Fax:214-377-9999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-02
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0082347332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5504480001Medicare NSC