Provider Demographics
NPI:1770281214
Name:CARTER MEDICAL EQUIPMENT & SUPPLIES
Entity type:Organization
Organization Name:CARTER MEDICAL EQUIPMENT & SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:LATITIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-934-8530
Mailing Address - Street 1:205 E CAMP WISDOM RD STE B
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-2773
Mailing Address - Country:US
Mailing Address - Phone:469-934-8530
Mailing Address - Fax:469-513-2651
Practice Address - Street 1:205 E CAMP WISDOM RD STE B
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-2773
Practice Address - Country:US
Practice Address - Phone:469-934-8530
Practice Address - Fax:469-513-2651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2024-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1003265OtherTEXAS DEPARTMENT OF STATE HEALTH SERVICES