Provider Demographics
NPI:1023450376
Name:PLATINUM SIGNATURE SERVICES LLC
Entity type:Organization
Organization Name:PLATINUM SIGNATURE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:GILMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-535-4884
Mailing Address - Street 1:1001 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-5011
Mailing Address - Country:US
Mailing Address - Phone:832-535-4884
Mailing Address - Fax:
Practice Address - Street 1:1001 COUNTRY CLUB DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-5011
Practice Address - Country:US
Practice Address - Phone:832-535-4884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-26
Last Update Date:2013-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies