Provider Demographics
NPI:1922477322
Name:COWBOY DME, LLC
Entity Type:Organization
Organization Name:COWBOY DME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BRITTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-679-0954
Mailing Address - Street 1:7122A W I 40
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2503
Mailing Address - Country:US
Mailing Address - Phone:806-679-0954
Mailing Address - Fax:
Practice Address - Street 1:7122A W I 40
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2503
Practice Address - Country:US
Practice Address - Phone:806-679-0954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-16
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies