Provider Demographics
NPI:1629319041
Name:UNION MEDICAL SUPPLIES & EQUIPMENT, LLC
Entity Type:Organization
Organization Name:UNION MEDICAL SUPPLIES & EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-531-2507
Mailing Address - Street 1:327 CEDAR CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75137-3936
Mailing Address - Country:US
Mailing Address - Phone:469-531-2507
Mailing Address - Fax:888-745-9691
Practice Address - Street 1:327 CEDAR CREEK DR
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-3936
Practice Address - Country:US
Practice Address - Phone:469-531-2507
Practice Address - Fax:888-745-9691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1001071332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies