Provider Demographics
NPI:1255734158
Name:BASSWOOD DURABLE MEDICAL EQUIPMENT
Entity type:Organization
Organization Name:BASSWOOD DURABLE MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:TANG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:877-974-6467
Mailing Address - Street 1:1001 E HEBRON PKWY
Mailing Address - Street 2:SUITE 118-106
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-1002
Mailing Address - Country:US
Mailing Address - Phone:877-974-6467
Mailing Address - Fax:877-958-7837
Practice Address - Street 1:1001 E HEBRON PKWY
Practice Address - Street 2:SUITE 118-106
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-1002
Practice Address - Country:US
Practice Address - Phone:877-974-6467
Practice Address - Fax:877-958-7837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-06
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies