Provider Demographics
NPI:1447232442
Name:MANGOLD MEMORIAL HOME MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:MANGOLD MEMORIAL HOME MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-652-2834
Mailing Address - Street 1:214 N MAIN
Mailing Address - Street 2:
Mailing Address - City:LOCKNEY
Mailing Address - State:TX
Mailing Address - Zip Code:79241
Mailing Address - Country:US
Mailing Address - Phone:806-652-2834
Mailing Address - Fax:806-652-2836
Practice Address - Street 1:214 N MAIN
Practice Address - Street 2:
Practice Address - City:LOCKNEY
Practice Address - State:TX
Practice Address - Zip Code:79241
Practice Address - Country:US
Practice Address - Phone:806-652-2834
Practice Address - Fax:806-652-2836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1320140001Medicare ID - Type UnspecifiedHOME MEDICAL EQUIPMENT