| Ttuhsc - Dme | |
|
3601 4th St Ste 2a100 Lubbock TX 79430-0002 | |
| (806) 743-2898 | |
| (806) 743-2787 |
| Full Name | Ttuhsc - Dme |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies |
| Location | 3601 4th St, Lubbock, Texas |
| Authorized Official Name and Position | Brent Majors (ASSISTANT DEAN OF FINANCE ADMIN) |
| Authorized Official Contact | 8067431830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ttuhsc - Dme Po Box 5865 Lubbock TX 79408-5865 Ph: (806) 743-2898 | Ttuhsc - Dme 3601 4th St Ste 2a100 Lubbock TX 79430-0002 Ph: (806) 743-2898 |
| NPI Number | 1053458026 |
|---|---|
| Provider Enumeration Date | 01/31/2007 |
| Last Update Date | 09/19/2013 |
| Medicare PECOS PAC ID | 4385549674 |
|---|---|
| Medicare Enrollment ID | O20100930029584 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053458026 | NPI | - | NPPES |
| 084588503 | Medicaid | TX | |
| 084588504 | Medicaid | TX | |
| 084588506 | Medicaid | TX | |
| CD9207 | Other | TX | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Primary |
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