Provider Demographics
NPI:1508948811
Name:MMS EQUIPMENT OF FORT WORTH, INC
Entity Type:Organization
Organization Name:MMS EQUIPMENT OF FORT WORTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-589-0759
Mailing Address - Street 1:7415 WHITEHALL ST
Mailing Address - Street 2:SUITE 113
Mailing Address - City:RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76118-6427
Mailing Address - Country:US
Mailing Address - Phone:817-589-0759
Mailing Address - Fax:817-284-1798
Practice Address - Street 1:7415 WHITEHALL ST
Practice Address - Street 2:SUITE 113
Practice Address - City:RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76118-6427
Practice Address - Country:US
Practice Address - Phone:817-589-0759
Practice Address - Fax:817-284-1798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TX0036377332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXBLUE CROSS TXOther519689
TX012015601Medicaid
TXBLUE CROSS TXOther519689