Provider Demographics
NPI:1609107226
Name:RJ MADSEN ENTERPRISES, LLC
Entity Type:Organization
Organization Name:RJ MADSEN ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MADSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-441-9829
Mailing Address - Street 1:5109 82ND ST
Mailing Address - Street 2:SUITE 7-144
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-3028
Mailing Address - Country:US
Mailing Address - Phone:806-441-9829
Mailing Address - Fax:806-771-3559
Practice Address - Street 1:7602 UNIVERSITY AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2137
Practice Address - Country:US
Practice Address - Phone:806-771-3558
Practice Address - Fax:806-771-3559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies