Provider Demographics
NPI:1306320163
Name:FINISH LINE DME & MEDICAL SUPPLY, LLC
Entity type:Organization
Organization Name:FINISH LINE DME & MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-674-8257
Mailing Address - Street 1:3640 MARQUIS DR STE F
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-7500
Mailing Address - Country:US
Mailing Address - Phone:972-272-0392
Mailing Address - Fax:972-272-0391
Practice Address - Street 1:3640 MARQUIS DR STE F
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-7500
Practice Address - Country:US
Practice Address - Phone:972-272-0392
Practice Address - Fax:972-272-0391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies