Provider Demographics
NPI:1821166463
Name:ACCURATE MEDICAL EQUIPMENT AND SUPPLY CO., INC.
Entity Type:Organization
Organization Name:ACCURATE MEDICAL EQUIPMENT AND SUPPLY CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:M
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-878-5030
Mailing Address - Street 1:1214 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4803
Mailing Address - Country:US
Mailing Address - Phone:817-878-5030
Mailing Address - Fax:817-878-5127
Practice Address - Street 1:120 INDUSTRIAL AVE
Practice Address - Street 2:
Practice Address - City:AZLE
Practice Address - State:TX
Practice Address - Zip Code:76020-2934
Practice Address - Country:US
Practice Address - Phone:817-444-0013
Practice Address - Fax:817-444-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX015401-0002OtherPACIFICARE PROVIDER
TX8540617OtherAETNA NON HMO PROVIDER
TX0616588OtherAETNA HMO PROVIDER
TX530801OtherBCBS OF TEXAS PROVIDER
TX645665OtherUNITED HEALTHCARE