Provider Demographics
NPI:1457573909
Name:VAUGHN MEDICAL EQUIPMENT REPAIR SERVICE LLC
Entity Type:Organization
Organization Name:VAUGHN MEDICAL EQUIPMENT REPAIR SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-833-8705
Mailing Address - Street 1:810 N M L KING JR PKWY
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77701-1640
Mailing Address - Country:US
Mailing Address - Phone:409-833-8705
Mailing Address - Fax:409-833-6626
Practice Address - Street 1:810 N M L KING JR PKWY
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-1640
Practice Address - Country:US
Practice Address - Phone:409-833-8705
Practice Address - Fax:409-833-6626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies