Provider Demographics
NPI:1588839005
Name:SOUTHMOST AREA MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:SOUTHMOST AREA MEDICAL EQUIPMENT LLC
Other - Org Name:SOUTHMOST AREA MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/MBR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NOELIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:956-544-8080
Mailing Address - Street 1:5235 SOUTHMOST RD
Mailing Address - Street 2:STE D
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78521-8052
Mailing Address - Country:US
Mailing Address - Phone:956-544-8080
Mailing Address - Fax:956-544-8082
Practice Address - Street 1:5235 SOUTHMOST RD
Practice Address - Street 2:STE D
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-8052
Practice Address - Country:US
Practice Address - Phone:956-544-8080
Practice Address - Fax:956-544-8082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0094393332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148730801Medicaid
TX148731601Medicaid
6109830001Medicare NSC