Provider Demographics
NPI:1932497948
Name:ORTHOCARE DURABLE MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:ORTHOCARE DURABLE MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GODFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:YAMOAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-743-2174
Mailing Address - Street 1:4017 BUENA VISTA ST STE,114
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204
Mailing Address - Country:US
Mailing Address - Phone:972-743-2174
Mailing Address - Fax:866-399-5527
Practice Address - Street 1:4017 BUENA VISTA ST,STE 114
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204
Practice Address - Country:US
Practice Address - Phone:972-743-2174
Practice Address - Fax:866-399-5527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX801442596332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies