Provider Demographics
NPI:1972596195
Name:METROCARE HOME MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:METROCARE HOME MEDICAL EQUIPMENT, INC.
Other - Org Name:ARLINGTON HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:LEEROY
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-606-0222
Mailing Address - Street 1:509 W RANDOL MILL RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-5737
Mailing Address - Country:US
Mailing Address - Phone:817-261-2536
Mailing Address - Fax:
Practice Address - Street 1:509 W RANDOL MILL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-5737
Practice Address - Country:US
Practice Address - Phone:817-261-2536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:METROCARE HOME MEDICAL EQUIPMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-08-23
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0079542332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141801401Medicaid
TX141801401Medicaid