Provider Demographics
NPI:1750699823
Name:TOTAL CARE DME & SUPPLIES LLC
Entity type:Organization
Organization Name:TOTAL CARE DME & SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:M
Authorized Official - Last Name:BLANDON
Authorized Official - Suffix:
Authorized Official - Credentials:CFTS
Authorized Official - Phone:214-330-4300
Mailing Address - Street 1:4373 S HAMPTON RD
Mailing Address - Street 2:STE. 2
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75232-1058
Mailing Address - Country:US
Mailing Address - Phone:214-330-4300
Mailing Address - Fax:866-648-1924
Practice Address - Street 1:4373 S HAMPTON RD
Practice Address - Street 2:STE. 2
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75232-1058
Practice Address - Country:US
Practice Address - Phone:214-330-4300
Practice Address - Fax:866-648-1924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0098314332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1888125-02Medicaid
TX1888125-01Medicaid
TX5968320001Medicare NSC