Provider Demographics
NPI:1750389052
Name:FIRST CLASS MEDICAL EQUIPMENT AND SUPPLY, INC.
Entity type:Organization
Organization Name:FIRST CLASS MEDICAL EQUIPMENT AND SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HEATON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-696-9363
Mailing Address - Street 1:55 LYERLY ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77022-3062
Mailing Address - Country:US
Mailing Address - Phone:713-696-9363
Mailing Address - Fax:713-696-9321
Practice Address - Street 1:55 LYERLY ST
Practice Address - Street 2:SUITE 300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-3062
Practice Address - Country:US
Practice Address - Phone:713-696-9363
Practice Address - Fax:713-696-9321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0062942332BX2000X, 332B00000X
TXTX 14425332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164676201Medicaid
TX164676204Medicaid
TX164676202Medicaid
TX164676203Medicaid
TX531963OtherBCBS TX PROVIDER NUMBER
TX164676204Medicaid
TX164676202Medicaid