Organization Name: | AMERICAN EAGLE MEDICAL SUPPLY |
NPI Number: | 1598038564 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JASON M HOLMES (OWNER) |
Mailing Address: | 2612 N Main St Vidor |
State: | TX US |
Postal Code: | 776622674 |
Phone Number: | 4097693897 |
Fax Number: | 4097839758 |
NPI Enumeration Date: | 02/21/2012 |
NPI Last Update Date: | 02/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 1000851 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
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 |