Provider Demographics
NPI:1891039400
Name:FRIENDLY HEALTH SERVICES DME
Entity Type:Organization
Organization Name:FRIENDLY HEALTH SERVICES DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRACIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-802-4550
Mailing Address - Street 1:2101 N 11TH ST
Mailing Address - Street 2:ST#A
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-4143
Mailing Address - Country:US
Mailing Address - Phone:956-618-4770
Mailing Address - Fax:
Practice Address - Street 1:2101 N 11TH ST
Practice Address - Street 2:ST#A
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-4143
Practice Address - Country:US
Practice Address - Phone:956-618-4770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies