Health Shack Medical Equipment & Supply Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

1000071 Issued in TX

Legal business name

HEALTH SHACK MEDICAL EQUIPMENT & SUPPLY INC.

Practice address

610 Murphy Rd
Suite 107
Stafford, TX 77477-5926

Phone

(281) 261-9616

Fax

(281) 261-2013

NPI assigned

Apr 8, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Willie Nathaniel Long IIINPI 1659441194

Title

Ceo/President

Phone

(281) 261-9616

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Willie Nathaniel Long III

  • Durable Medical Equipment & Medical Supplies
  • Stafford, TX
  • NPI 1659441194
  NPD (past) Authorized official

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1689990137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 MURPHY RD",
            "address_2": "SUITE 107",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774775926",
            "telephone_number": "281-261-9616",
            "fax_number": "281-261-2013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 MURPHY RD",
            "address_2": "SUITE 107",
            "city": "STAFFORD",
            "state": "TX",
            "postal_code": "774775926",
            "telephone_number": "281-261-9616",
            "fax_number": "281-261-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH SHACK MEDICAL EQUIPMENT & SUPPLY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "NATHANIEL",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "281-261-9616",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "1000071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Stafford, TX
• Providers in Stafford, 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 Apr 8, 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.