Provider Demographics
NPI:1609953744
Name:MATHEWS RENTAL INC
Entity Type:Organization
Organization Name:MATHEWS RENTAL INC
Other - Org Name:MATHEWS MEDICAL EQUIPMENT & SUPPLIES
Other - Org Type:Other Name
Authorized Official - Title/Position:SEC/TREA
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:S
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-275-3485
Mailing Address - Street 1:112 W COLUMBIA STREET
Mailing Address - Street 2:P O BOX 207
Mailing Address - City:SAN AUGUSTINE
Mailing Address - State:TX
Mailing Address - Zip Code:75972-0207
Mailing Address - Country:US
Mailing Address - Phone:936-275-3485
Mailing Address - Fax:936-275-5424
Practice Address - Street 1:112 W COLUMBIA STREET
Practice Address - Street 2:
Practice Address - City:SAN AUGUSTINE
Practice Address - State:TX
Practice Address - Zip Code:75972-0207
Practice Address - Country:US
Practice Address - Phone:936-275-3485
Practice Address - Fax:936-275-5424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0035618332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0107070-01Medicaid
TX0156382-01Medicaid
TX0107070-01Medicaid