Provider Demographics
NPI:1811578354
Name:ESSENTIAL DME
Entity Type:Organization
Organization Name:ESSENTIAL DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ANNEBELLE
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:ROQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-430-6327
Mailing Address - Street 1:431 ISOM RD STE 222
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-5108
Mailing Address - Country:US
Mailing Address - Phone:210-982-3264
Mailing Address - Fax:210-982-3261
Practice Address - Street 1:431 ISOM RD STE 222
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-5108
Practice Address - Country:US
Practice Address - Phone:210-982-3264
Practice Address - Fax:210-982-3261
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANGEL MED TECH, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-16
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies