Provider Demographics
NPI:1891276499
Name:THEPE ENTERPRISE
Entity Type:Organization
Organization Name:THEPE ENTERPRISE
Other - Org Name:UNIVERSAL MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ETIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-380-9093
Mailing Address - Street 1:105 N GREENVILLE AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-2295
Mailing Address - Country:US
Mailing Address - Phone:800-380-9093
Mailing Address - Fax:972-957-8003
Practice Address - Street 1:105 N GREENVILLE AVE STE 105-12
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-2294
Practice Address - Country:US
Practice Address - Phone:800-380-9093
Practice Address - Fax:972-957-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BP3500X
1001500332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition