Provider Demographics
NPI:1851329288
Name:SCEPANSKI DURABLE MEDICAL SUPPLIES, LTD
Entity type:Organization
Organization Name:SCEPANSKI DURABLE MEDICAL SUPPLIES, LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:SCEPANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-383-5132
Mailing Address - Street 1:4801 W UNIVERSITY DR STE B
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-9426
Mailing Address - Country:US
Mailing Address - Phone:956-383-5132
Mailing Address - Fax:956-383-6362
Practice Address - Street 1:4801 W UNIVERSITY DR STE B
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-9426
Practice Address - Country:US
Practice Address - Phone:956-383-5132
Practice Address - Fax:956-383-6362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0087449332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188403303Medicaid
TX5685100002Medicare NSC