Provider Demographics
NPI:1710947155
Name:CPAP STORE, INC
Entity Type:Organization
Organization Name:CPAP STORE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:ATP
Authorized Official - Phone:972-480-0500
Mailing Address - Street 1:777 N GROVE RD
Mailing Address - Street 2:STE 115
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-2760
Mailing Address - Country:US
Mailing Address - Phone:972-480-0500
Mailing Address - Fax:972-480-0501
Practice Address - Street 1:777 N GROVE RD
Practice Address - Street 2:STE 115
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-2760
Practice Address - Country:US
Practice Address - Phone:972-480-0500
Practice Address - Fax:972-480-0501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0084058332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6419630001Medicare NSC