Provider Demographics
NPI:1972341493
Name:SILVER LINE NRB LLC
Entity type:Organization
Organization Name:SILVER LINE NRB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ BLANCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-242-8829
Mailing Address - Street 1:2351 W NORTHWEST HWY STE 3238
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75220-4433
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2351 W NORTHWEST HWY STE 3238
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-4433
Practice Address - Country:US
Practice Address - Phone:214-242-8829
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies