Provider Demographics
NPI:1992854962
Name:FRANK'S MEDICAL MART, INC
Entity Type:Organization
Organization Name:FRANK'S MEDICAL MART, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:FARNIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-832-3481
Mailing Address - Street 1:2405 MCFADDIN ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1921
Mailing Address - Country:US
Mailing Address - Phone:409-832-3481
Mailing Address - Fax:409-832-3787
Practice Address - Street 1:2405 MCFADDIN ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1921
Practice Address - Country:US
Practice Address - Phone:409-832-3481
Practice Address - Fax:409-832-3787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0012940332B00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX015528501Medicaid
TX015528501Medicaid
TX0332720004Medicare NSC
LA0332720003Medicare NSC
TX0332720001Medicare NSC