Provider Demographics
NPI:1952450942
Name:LIFEWAY MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:LIFEWAY MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:STENGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-714-0011
Mailing Address - Street 1:7200 STATE HIGHWAY 161
Mailing Address - Street 2:STE 130
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-4132
Mailing Address - Country:US
Mailing Address - Phone:972-714-0014
Mailing Address - Fax:855-501-0111
Practice Address - Street 1:1717 PRECINCT LINE RD STE 105
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3169
Practice Address - Country:US
Practice Address - Phone:972-714-0014
Practice Address - Fax:855-501-0111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5898710001Medicare NSC