Medall, Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

5468630001 Issued in TX

Legal business name

MEDALL, INC.

Practice address

221 W Exchange Ave
Suite 303
Fort Worth, TX 76164-9614

Phone

(817) 626-9991

Fax

(817) 626-0920

NPI assigned

Jul 10, 2006

Organization subpart

No

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

Authorized official

Name

Mike Scott Wilburn, OP

Title

President

Phone

(817) 626-9991

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1649204694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 185132",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761810132",
            "telephone_number": "817-626-9991",
            "fax_number": "817-626-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W EXCHANGE AVE",
            "address_2": "SUITE 303",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761649614",
            "telephone_number": "817-626-9991",
            "fax_number": "817-626-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDALL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "WILBURN",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-626-9991",
        "authorized_official_credential": "OP"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "5468630001",
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "TX",
            "license": "5468630001",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177887001",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "177887002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Medalife Care Transport
• Medalife Care Transport
• Heidi L Medcalf, PA
• Medcare Diagnostics of America
• Elise Marie Mederos, M.A., LPC
• Elizabeth Irene Mederos, LMSW
• Gerardo Mederos, MD

• Durable Medical Equipment & Medical Supplies in Fort Worth, TX
• Providers in Fort Worth, 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 8, 2008; 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.