Provider Demographics
NPI: | 1598486631 |
---|---|
Name: | ACE MEDICAL EQUIPMENT, LLC |
Entity type: | Organization |
Organization Name: | ACE MEDICAL EQUIPMENT, LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | AUTHORIZED OFFICAL |
Authorized Official - Prefix: | |
Authorized Official - First Name: | KHALIL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SHAFIQ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 512-750-4858 |
Mailing Address - Street 1: | 9415 BURNET RD STE 306 |
Mailing Address - Street 2: | |
Mailing Address - City: | AUSTIN |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78758-5397 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 512-909-8571 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 9415 BURNET RD STE 306 |
Practice Address - Street 2: | |
Practice Address - City: | AUSTIN |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78758-5397 |
Practice Address - Country: | US |
Practice Address - Phone: | 512-909-8571 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2022-09-07 |
Last Update Date: | 2024-06-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | |
No | 332BP3500X | Suppliers | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition |