Provider Demographics
NPI:1437371044
Name:MEDIC SUPPLY & EQUIPMENT COMPANY, INC.
Entity Type:Organization
Organization Name:MEDIC SUPPLY & EQUIPMENT COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE AGENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:LORENZO
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-324-2041
Mailing Address - Street 1:2329 STOP 23 B
Mailing Address - Street 2:
Mailing Address - City:ZAPATA
Mailing Address - State:TX
Mailing Address - Zip Code:78076-2329
Mailing Address - Country:US
Mailing Address - Phone:956-765-8495
Mailing Address - Fax:956-765-9670
Practice Address - Street 1:2329 STOP 23 B
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-2329
Practice Address - Country:US
Practice Address - Phone:956-765-8495
Practice Address - Fax:956-765-9670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies