Provider Demographics
NPI:1770948747
Name:URBAN DURABLE MEDICAL EQUIPMENT
Entity type:Organization
Organization Name:URBAN DURABLE MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RONNIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-337-4700
Mailing Address - Street 1:7310 S WESTMORELAND RD STE 1
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3002
Mailing Address - Country:US
Mailing Address - Phone:214-337-4700
Mailing Address - Fax:972-709-2847
Practice Address - Street 1:7310 S WESTMORELAND RD STE 1
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3002
Practice Address - Country:US
Practice Address - Phone:214-337-4700
Practice Address - Fax:972-709-2847
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:URBAN HEALTH SYSTEMS P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-17
Last Update Date:2019-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies