American Eagle Medical Supply

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1000851 Issued in TX

Legal business name

AMERICAN EAGLE MEDICAL SUPPLY

Practice address

2612 N Main St
Vidor, TX 77662-2674

Phone

(409) 769-3897

Fax

(409) 783-9758

NPI assigned

Feb 21, 2012

Last updated

Feb 21, 2012By 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

Jason M Holmes

Title

Owner

Phone

(409) 769-3897

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329782400000",
    "number": "1598038564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2612 N MAIN ST",
            "city": "VIDOR",
            "state": "TX",
            "postal_code": "776622674",
            "telephone_number": "409-769-3897",
            "fax_number": "409-783-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 N MAIN ST",
            "city": "VIDOR",
            "state": "TX",
            "postal_code": "776622674",
            "telephone_number": "409-769-3897",
            "fax_number": "409-783-9758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN EAGLE MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-21",
        "last_updated": "2012-02-21",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "409-769-3897"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "1000851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendi Ellen Ames, APRN, FNP-C
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• Charlene Ashworth
• Christyna Badeaux, PT
• Karine A Bah

• Durable Medical Equipment & Medical Supplies in Vidor, TX
• Providers in Vidor, 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 Feb 21, 2012; 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.