Provider Demographics
NPI:1124143086
Name:TUCKER MEDICAL EQUIPMENT & HOME HEALTH SERVICES
Entity type:Organization
Organization Name:TUCKER MEDICAL EQUIPMENT & HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT- CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:417-235-5588
Mailing Address - Street 1:722 E BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MONETT
Mailing Address - State:MO
Mailing Address - Zip Code:65708-2109
Mailing Address - Country:US
Mailing Address - Phone:417-235-5588
Mailing Address - Fax:417-235-3477
Practice Address - Street 1:722 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MONETT
Practice Address - State:MO
Practice Address - Zip Code:65708-2109
Practice Address - Country:US
Practice Address - Phone:417-235-5588
Practice Address - Fax:417-235-3477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO4842420001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER