Provider Demographics
NPI:1942646245
Name:SHOW ME MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:SHOW ME MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:VASTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-256-2526
Mailing Address - Street 1:1208 PORTER WAGONER BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:WEST PLAINS
Mailing Address - State:MO
Mailing Address - Zip Code:65775-1854
Mailing Address - Country:US
Mailing Address - Phone:417-256-2526
Mailing Address - Fax:417-256-2079
Practice Address - Street 1:1208 PORTER WAGONER BLVD STE 3
Practice Address - Street 2:
Practice Address - City:WEST PLAINS
Practice Address - State:MO
Practice Address - Zip Code:65775-1854
Practice Address - Country:US
Practice Address - Phone:417-256-2526
Practice Address - Fax:417-256-2079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1942646245Medicaid
MO1942646245Medicaid