Mineral Wells Medical Supply, Inc.

Primary specialty

Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X

Legal business name

MINERAL WELLS MEDICAL SUPPLY, INC.

Doing business as

Graham Medical Supply

Practice address

1706 State Highway 16 S
Graham, TX 76450-4606

Phone

(940) 452-1986

NPI assigned

May 3, 2021

Last updated

Oct 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Rebbekah Davis

Title

Owner

Phone

(940) 521-9460

Specialties & licenses 1

Addresses

Other names 1

• Graham Medical Supply Doing business as

Locations

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634256000000",
    "number": "1275116741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1152",
            "city": "MINERAL WELLS",
            "state": "TX",
            "postal_code": "760681152",
            "telephone_number": "940-521-9460",
            "fax_number": "940-521-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 STATE HIGHWAY 16 S",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764504606",
            "telephone_number": "940-452-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINERAL WELLS MEDICAL SUPPLY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-03",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "REBBEKAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-521-9460"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Graham Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Graham Medical Supply",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oxygen Equipment & Supplies (DME) in Graham, TX
• Providers in Graham, TX by specialty
• Oxygen Equipment & Supplies (DME) in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.