Provider Demographics
NPI:1588797971
Name:ROLLING PLAINS MEDICAL SUPPLY
Entity type:Organization
Organization Name:ROLLING PLAINS MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-235-4366
Mailing Address - Street 1:1410 LAMAR ST
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TX
Mailing Address - Zip Code:79556-7124
Mailing Address - Country:US
Mailing Address - Phone:325-235-4366
Mailing Address - Fax:325-235-4852
Practice Address - Street 1:1410 LAMAR ST
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TX
Practice Address - Zip Code:79556-7124
Practice Address - Country:US
Practice Address - Phone:325-235-4366
Practice Address - Fax:325-235-4852
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0075594332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX531613OtherBLUECROSSBLUESHIELD
TX4231340001Medicare ID - Type Unspecified