Provider Demographics
NPI:1306143490
Name:UROMED, INC.
Entity type:Organization
Organization Name:UROMED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:L
Authorized Official - Last Name:HINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-841-1233
Mailing Address - Street 1:3975 JOHNS CREEK CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1298
Mailing Address - Country:US
Mailing Address - Phone:800-841-1233
Mailing Address - Fax:678-417-0139
Practice Address - Street 1:3080 W INTERSTATE 20 STE A
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-8048
Practice Address - Country:US
Practice Address - Phone:972-337-3447
Practice Address - Fax:678-417-0139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-25
Last Update Date:2018-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX011908301Medicaid
TX531435OtherBCBS TX
1067660005Medicare NSC
TX011908301Medicaid