Provider Demographics
NPI:1689745283
Name:ZION DURABLE MEDICAL EQUIPMENT, LLC
Entity Type:Organization
Organization Name:ZION DURABLE MEDICAL EQUIPMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRASCO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:956-797-9999
Mailing Address - Street 1:401 JAMES RICHARD CLOSNER DR
Mailing Address - Street 2:A BX 1
Mailing Address - City:LA FERIA
Mailing Address - State:TX
Mailing Address - Zip Code:78559-3057
Mailing Address - Country:US
Mailing Address - Phone:956-797-9999
Mailing Address - Fax:956-797-9990
Practice Address - Street 1:401 JAMES RICHARD CLOSNER DR
Practice Address - Street 2:A BOX 1
Practice Address - City:LA FERIA
Practice Address - State:TX
Practice Address - Zip Code:78559-3057
Practice Address - Country:US
Practice Address - Phone:956-797-9999
Practice Address - Fax:956-797-9990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184218901OtherMEDICAID CROSSOVER
TX184218902Medicaid
TX5832900001Medicare NSC