Provider Demographics
NPI:1700837994
Name:ORTHO-MED-EQUIP, INC.
Entity Type:Organization
Organization Name:ORTHO-MED-EQUIP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRYSTIE
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:SCHULTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-216-4490
Mailing Address - Street 1:662 10TH ST
Mailing Address - Street 2:BUILDING B
Mailing Address - City:FLORESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78114-3124
Mailing Address - Country:US
Mailing Address - Phone:830-216-4490
Mailing Address - Fax:830-216-4242
Practice Address - Street 1:662 10TH ST
Practice Address - Street 2:BUILDING B
Practice Address - City:FLORESVILLE
Practice Address - State:TX
Practice Address - Zip Code:78114-3124
Practice Address - Country:US
Practice Address - Phone:830-216-4490
Practice Address - Fax:830-216-4242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-13
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0066663332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX531782OtherBLUECROSS BLUESHIELD
TX161866201Medicaid
TX161866201Medicaid