Dura Med, Inc.
Organization Active NPI Durable Medical Equipment & Medical Supplies · Llano, TX
NPI 1104982560 · NPPES record last updated Feb 9, 2016
Key facts
- NPI
- 1104982560
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Durable Medical Equipment & Medical Supplies 332B00000X
- License
- 0083377 (TX)
- Legal business name
- DURA MED, INC.
- Practice address
- 600 Bessemer Ave
Llano, TX 78643-1608 - Phone
- (325) 247-4155
- Fax
- (325) 247-5554
- NPI assigned
- Dec 29, 2006
- Organization subpart
- No
Authorized official
- Name
- Cresta Tate
- Title
- Manager
- Phone
- (512) 756-8550
Other NPIs on the same Medicare enrollment 2
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 5
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041028000676 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 4385605666 |
2 other NPIs on this enrollment Practice locations: Llano, TX |
National Provider Directory
- Tax ID family
- Dura Med Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 0083377 | TX | Yes |
| Oxygen Equipment & Supplies (DME) | 332BX2000X | 0083377 | TX |
Addresses
Primary practice location
600 Bessemer Ave
Llano, TX 78643-1608
Mailing address
600 Bessemer Ave
Llano, TX 78643-1608
Phone (325) 247-4155
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0916991-01 | Medicaid | TX | |
| 0916991-03 | Medicaid | TX |
Other names
- Corner Drug Store and Medical Equipment
Other providers in Llano, TX
- Clear Creek Dermatology
- Howell Anson Cone
- Coryell County Memorial Hospital Authority
- Dignity Healthcare II LLC
- Dura Med, Inc.
- Dura Med, Inc.
- Duramed
- Educare Community Living Limited Partnership
- Jeri Lynnette Epley
- Scott Esse
All providers in Llano, TX · Durable Medical Equipment & Medical Supplies in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.