Provider Demographics
NPI: | 1992708572 |
---|---|
Name: | MES TEAM, INC. |
Entity type: | Organization |
Organization Name: | MES TEAM, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TAMMY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SESSIONS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 308-635-1017 |
Mailing Address - Street 1: | 3802 AVENUE B |
Mailing Address - Street 2: | |
Mailing Address - City: | SCOTTSBLUFF |
Mailing Address - State: | NE |
Mailing Address - Zip Code: | 69361-4653 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 308-635-1017 |
Mailing Address - Fax: | 308-635-7550 |
Practice Address - Street 1: | 3802 AVENUE B |
Practice Address - Street 2: | |
Practice Address - City: | SCOTTSBLUFF |
Practice Address - State: | NE |
Practice Address - Zip Code: | 69361-4653 |
Practice Address - Country: | US |
Practice Address - Phone: | 308-635-1017 |
Practice Address - Fax: | 308-635-7550 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2005-05-27 |
Last Update Date: | 2014-06-10 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NE | 10025162600 | Medicaid | |
NE | 10025162600 | Medicaid |