Providacare Medical Supply LTD

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PROVIDACARE MEDICAL SUPPLY LTD

Practice address

1300 Hwy 281
Marble Falls, TX 78654-4504

Phone

(830) 693-7313

Fax

(830) 693-7363

NPI assigned

Oct 3, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ryan N Bennett

Title

Ceo

Phone

(512) 733-6518

Specialties & licenses 1

Addresses

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

• Freedom Respiratory Solutions, LLC

  • Oxygen Equipment & Supplies (DME)
  • Detroit Lakes, MN
  • NPI 1023254216

  Member Of

  NPD member
• Freedom Respiratory Solutions, LLC

  • Durable Medical Equipment & Medical Supplies
  • Saint Cloud, MN
  • NPI 1467603829

  Member Of

  NPD member
• Freedom Respiratory Solutions, LLC

  • Oxygen Equipment & Supplies (DME)
  • Duluth, MN
  • NPI 1538233978

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283126400000",
    "number": "1033360490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3721 EXECUTIVE CENTER DR",
            "address_2": "SUITE 102",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787311645",
            "telephone_number": "512-733-6518",
            "fax_number": "512-795-9185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 HWY 281",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786544504",
            "telephone_number": "830-693-7313",
            "fax_number": "830-693-7363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDACARE MEDICAL SUPPLY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2010-08-30",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-733-6518",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brianne Neal Poole, O.D.
• Mohan Valentino Poole, O.D.
• Amy Ports, OTR
• Micheal Dean Ports, CRNA
• Precision Optical of Central Texas Inc.
• Frank Pucar Jr.
• Betsy C Pyle
• Quality First Home Health Care, LLC
• Quality First Home Health Care, LLC
• Brad Thomas Quinn, OTR

• Durable Medical Equipment & Medical Supplies in Marble Falls, TX
• Providers in Marble Falls, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.