Organization Name: | ADVANCED ELITE DME |
NPI Number: | 1114399144 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MAURICIO GUTFRAJND (QUALITY CONTROL MANAGER) |
Mailing Address: | 1165 E Main St Ste D Alice |
State: | TX US |
Postal Code: | 783325046 |
Phone Number: | 7875671117 |
Fax Number: | |
NPI Enumeration Date: | 10/29/2015 |
NPI Last Update Date: | 10/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BX2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Oxygen Equipment & Supplies |
Taxonomy Definition: |