Organization Name: | ICON MEDICAL SUPPLIES |
NPI Number: | 1538394309 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GREG YOUNG (PRINCIPAL) |
Mailing Address: | 2300 Mcdermott Rd Ste 200-199 Plano |
State: | TX US |
Postal Code: | 750257016 |
Phone Number: | 2143839105 |
Fax Number: | 2143839110 |
NPI Enumeration Date: | 05/22/2009 |
NPI Last Update Date: | 05/22/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |