Provider Demographics
NPI:1689619223
Name:AREA WIDE MEDICAL INC
Entity Type:Organization
Organization Name:AREA WIDE MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:RRT
Authorized Official - Phone:806-894-6551
Mailing Address - Street 1:110 CLUBVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-6304
Mailing Address - Country:US
Mailing Address - Phone:806-894-6551
Mailing Address - Fax:806-894-1630
Practice Address - Street 1:110 CLUBVIEW DR
Practice Address - Street 2:
Practice Address - City:LEVELLAND
Practice Address - State:TX
Practice Address - Zip Code:79336-6304
Practice Address - Country:US
Practice Address - Phone:806-894-6551
Practice Address - Fax:806-894-1630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX011372201Medicaid
TX0808520001Medicare NSC
TX0808520003Medicare NSC
TX011372201Medicaid