Provider Demographics
NPI:1669421798
Name:PEOPLES LINK MEDICAL EQUIPMENT AND SUPPLIES
Entity type:Organization
Organization Name:PEOPLES LINK MEDICAL EQUIPMENT AND SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:IBEKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-369-0400
Mailing Address - Street 1:5518 DYER STREET
Mailing Address - Street 2:#9
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206
Mailing Address - Country:US
Mailing Address - Phone:214-369-0400
Mailing Address - Fax:214-369-0408
Practice Address - Street 1:5518 DYER STREET
Practice Address - Street 2:#9
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206
Practice Address - Country:US
Practice Address - Phone:214-369-0400
Practice Address - Fax:214-369-0408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2009-05-15
Deactivation Date:2009-04-02
Deactivation Code:
Reactivation Date:2009-05-15
Provider Licenses
StateLicense IDTaxonomies
TX0088148332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182558001Medicaid
5699980001Medicare NSC