Provider Demographics
NPI:1912933664
Name:REDI-QUIP MEDICAL EQUIPMENT & SUPPLIES, INC.
Entity Type:Organization
Organization Name:REDI-QUIP MEDICAL EQUIPMENT & SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:281-492-2799
Mailing Address - Street 1:PO BOX 218418
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77218-8418
Mailing Address - Country:US
Mailing Address - Phone:281-492-2799
Mailing Address - Fax:281-492-7479
Practice Address - Street 1:16820 BARKER SPRINGS RD
Practice Address - Street 2:SUITE E500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-5040
Practice Address - Country:US
Practice Address - Phone:281-492-2799
Practice Address - Fax:281-492-7479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2009-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010744301Medicaid
TX82-00345OtherEVERCARE OF TEXAS
TX016560701Medicaid
TX530496OtherBLUE CROSS BLUE SHIELD
1141370001Medicare NSC