Provider Demographics
NPI:1649259797
Name:APPLE HOMECARE MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:APPLE HOMECARE MEDICAL SUPPLY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF QUALITY AND COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BULMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:651-789-0926
Mailing Address - Street 1:500 INDUSTRIAL DR
Mailing Address - Street 2:#100
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-6643
Mailing Address - Country:US
Mailing Address - Phone:972-699-9511
Mailing Address - Fax:972-437-1236
Practice Address - Street 1:500 INDUSTRIAL DR
Practice Address - Street 2:#100
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-6643
Practice Address - Country:US
Practice Address - Phone:972-699-9511
Practice Address - Fax:972-437-1236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-16
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX170552701332BC3200X
TX170552702332BN1400X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX170552701Medicaid
TX170552702Medicaid
TX10018504OtherAMERIGROUP HMO PROVIDER
TX170552703Medicaid
TX170552702Medicaid