Provider Demographics
NPI:1851614242
Name:FRESCAS MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:FRESCAS MEDICAL SUPPLIES LLC
Other - Org Name:U&T MEDICAL & RESPIRATORY SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FRESCAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-595-3941
Mailing Address - Street 1:509 GILES ROAD STE C
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79915-2725
Mailing Address - Country:US
Mailing Address - Phone:915-595-3941
Mailing Address - Fax:
Practice Address - Street 1:509 GILES ROAD
Practice Address - Street 2:SUITE C
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79915-2725
Practice Address - Country:US
Practice Address - Phone:915-599-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX213933902Medicaid
TX213933902Medicaid