Provider Demographics
NPI: | 1831496827 |
---|---|
Name: | MEDICAL EQUIPMENT DISTRIBUTORS II LP |
Entity Type: | Organization |
Organization Name: | MEDICAL EQUIPMENT DISTRIBUTORS II LP |
Other - Org Name: | THE MED GROUP |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | SENIOR VICE PRESIDENT & GENERAL MAN |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | JEFF |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | WOODHAM |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 800-825-5633 |
Mailing Address - Street 1: | 3223 S LOOP 289 |
Mailing Address - Street 2: | SUITE 600 |
Mailing Address - City: | LUBBOCK |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 79423-1337 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 800-825-5633 |
Mailing Address - Fax: | 806-792-4499 |
Practice Address - Street 1: | 3300 82ND ST |
Practice Address - Street 2: | SUITE F |
Practice Address - City: | LUBBOCK |
Practice Address - State: | TX |
Practice Address - Zip Code: | 79423-2045 |
Practice Address - Country: | US |
Practice Address - Phone: | 806-797-5280 |
Practice Address - Fax: | 806-797-5290 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-02-28 |
Last Update Date: | 2011-02-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |