MINERAL WELLS MEDICAL SUPPLY, INC


Address: 211 Sw 25th Ave, Mineral Wells, TX 76067-8241
Phone: 9403252706

MINERAL WELLS MEDICAL SUPPLY, INC (NPI# 1740205657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1740205657
Entity Type Organization
Organization Name MINERAL WELLS MEDICAL SUPPLY, INC
Practice Address 211 Sw 25th Ave
Mineral Wells
TX 76067-8241
Mailing Address Po Box 1152
Mineral Wells
TX 76068-1152
Practice Telephone 9403252706
Practice Fax Number 9403254130
Mailing Telephone 9403252706
Mailing Fax Number 9403254130
Enumeration Date 2006-07-12
Last Update Date 2012-05-04
Authorized Official Name MRS. REBBEKAH NADINE ANDRESS (PRESIDENT/OWNER)
Authorized Official Telephone 9403252706
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 332BX2000X Durable Medical Equipment & Medical Supplies
Specialization: Oxygen Equipment & Supplies
0035334 TX Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
TX BLUE CROSS BLUE SHIELD 513486 01
TX 087075001 05
TX AETNA MEDICAID 44995 01
TX 015895801 05

Office Location

Street Address 211 SW 25TH AVE
City MINERAL WELLS
State TX
Zip Code 76067-8241

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NPI Name Taxonomy Address Enumeration
1609392810 Jamie Lee Olsen Registered Nurse 2517 Highway 180 E Ste B, Mineral Wells, TX 76067 2017-08-18
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1710367305 Karin Denise Boggs Counselor 4113a Highway 180 East, Suite C, Mineral Wells, TX 76067 2015-06-09
1275786576 Debby Louise Polozeck Registered Nurse 202 Sw 25th Ave Ste 300, Mineral Wells, TX 76067 2008-10-30
1427252469 Ryan Freemyer Md Pa Surgery 214 Southwest 26th Avenue, Suite A, Mineral Wells, TX 76067 2007-06-13
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1407070758 Mineral Wells Women's Pavilion, P.a. Obstetrics & Gynecology 220 Sw 26th Avenue, Mineral Wells, TX 76067 2007-04-11
1871643007 Med Pavilion PC Pediatrics 220a Sw 26th Ave, Mineral Wells, TX 76067 2007-01-11
1003990615 Tim R Tarkenton Obstetrics & Gynecology 220 Sw 26th Ave, Mineral Wells, TX 76067 2006-10-24
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Taxonomy Information

Taxonomy Code 332BX2000X
Grouping Suppliers
Classification Durable Medical Equipment & Medical Supplies
Specialization Oxygen Equipment & Supplies

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1740897735 Extraordinary Home Health Care LLC Durable Medical Equipment & Medical Supplies 754 Bateswood Dr Apt 4, Houston, TX 77079-5711 2020-09-24
1013527290 Riptide Medical Supply, LLC Durable Medical Equipment & Medical Supplies 2408 Lexington Pl, Brownsville, TX 78520-3914 2020-08-03
1790300457 United Wellness Dme LLC Durable Medical Equipment & Medical Supplies 2611 N Texas Blvd Ste 3, Weslaco, TX 78599-4062 2020-06-09
1831711969 Brightstar Medical Supply Durable Medical Equipment & Medical Supplies 1006 N Sylvania Ave, Fort Worth, TX 76111-2516 2020-05-12
1568099232 Manuel F Huaman Durable Medical Equipment & Medical Supplies 19842 Portlick Ct, Katy, TX 77449-5737 2020-03-24
1265076806 Stateserv Medical of Texas Durable Medical Equipment & Medical Supplies 1207 N. Glenview Drive, Richardson, TX 75081 2019-11-06
1124673942 Integrity Dme Services LLC Durable Medical Equipment & Medical Supplies 6323 Sovereign Dr, Suite # 170 Ab, San Antonio, TX 78229 2019-08-08
1649823550 Thomas Edward Potter Durable Medical Equipment & Medical Supplies 135 Bonner Ave, Corsicana, TX 75110-9252 2019-07-19
1114587912 Curtis Downey Durable Medical Equipment & Medical Supplies 4914 Winnetka St, Houston, TX 77021-2932 2019-06-14
1700443330 Leticia Garcia Durable Medical Equipment & Medical Supplies 12077 Briargrove Ln, Forney, TX 75126-4132 2019-05-20
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Competitor

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City MINERAL WELLS
Zip Code 76067

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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