Provider Demographics
NPI:1821012444
Name:ACCUCARE QUALITY MEDICAL PRODUCTS INC
Entity Type:Organization
Organization Name:ACCUCARE QUALITY MEDICAL PRODUCTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:MOONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-384-1188
Mailing Address - Street 1:PO BOX 1990
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951-0021
Mailing Address - Country:US
Mailing Address - Phone:409-384-1188
Mailing Address - Fax:409-384-1199
Practice Address - Street 1:1530 SPRINGHILL RD
Practice Address - Street 2:SUITE A
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-9793
Practice Address - Country:US
Practice Address - Phone:409-384-1188
Practice Address - Fax:409-384-1199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0070704332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX162967701Medicaid
TX162967702Medicaid
TX5004210001Medicare Oscar/Certification
TX162967701Medicaid
TX162967702Medicaid