Provider Demographics
NPI:1770619405
Name:WEBB KOHLER MEDICAL EQUIPMENT AND SUPPLY
Entity type:Organization
Organization Name:WEBB KOHLER MEDICAL EQUIPMENT AND SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO PIC
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SALVANT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:817-861-4631
Mailing Address - Street 1:PO BOX 173189
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-3189
Mailing Address - Country:US
Mailing Address - Phone:817-861-4631
Mailing Address - Fax:817-861-4638
Practice Address - Street 1:2204 PARK SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013
Practice Address - Country:US
Practice Address - Phone:817-861-4631
Practice Address - Fax:817-861-4638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0040686332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10023587OtherAMERIGROUP
TX1812371000OtherACS US DEPT OF LABOR