Provider Demographics
NPI:1386973113
Name:HOUSTON MEDICAL EQUIPMENT LLC
Entity type:Organization
Organization Name:HOUSTON MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:RODERICK
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:MCLEOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-217-9421
Mailing Address - Street 1:96 TOMMY STALNAKER DR STE B
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-9179
Mailing Address - Country:US
Mailing Address - Phone:478-953-0345
Mailing Address - Fax:478-953-7054
Practice Address - Street 1:96 TOMMY STALNAKER DR STE B
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-9179
Practice Address - Country:US
Practice Address - Phone:478-953-0345
Practice Address - Fax:478-953-7054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-07
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6310590001Medicare NSC