Provider Demographics
NPI:1699831131
Name:MID-CITIES HOME MEDICAL EQUIPMENT CO. INC.
Entity Type:Organization
Organization Name:MID-CITIES HOME MEDICAL EQUIPMENT CO. INC.
Other - Org Name:HOMEPOINT - DME, HOMEPOINT HOME MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MGR.
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-641-7445
Mailing Address - Street 1:304 RED HAWK DR.
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052
Mailing Address - Country:US
Mailing Address - Phone:972-641-7445
Mailing Address - Fax:972-641-7465
Practice Address - Street 1:2112 RUTLAND DR
Practice Address - Street 2:STE 176
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758
Practice Address - Country:US
Practice Address - Phone:512-837-2533
Practice Address - Fax:512-837-0135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0010654332B00000X
TX0036337332BX2000X
332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX531150OtherBLUE CROSS BLUE SHIELD
TX1244780002Medicare ID - Type Unspecified
1244780002Medicare NSC