Elizabeth D.Ebolum

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

166130801 Issued in TX

Legal business name

ELIZABETH D.EBOLUM

Doing business as

Assured Medical Equipment & Supplies

Practice address

1704 N Hampton Rd
Ste 207
Desoto, TX 75115-8623

Phone

(972) 224-4500

Fax

(972) 224-4501

NPI assigned

Oct 25, 2006

Last updated

Nov 14, 2008By 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

Mrs. Elizabeth D Opaleye, RN

Title

Dir of Operations

Phone

(972) 224-4500

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Assured Medical Equipment & Supplies Doing business as

Tax ID family

Assured Medical Equipment and Supplies2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Assured Medical Equipment and Supplies

  • Durable Medical Equipment & Medical Supplies
  • Desoto, TX
  • NPI 1124205703
  NPD tax ID

Locations

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1790860344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1704 N HAMPTON RD",
            "address_2": "STE 207",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751158623",
            "telephone_number": "972-224-4500",
            "fax_number": "972-224-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 N HAMPTON RD",
            "address_2": "STE 207",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751158623",
            "telephone_number": "972-224-4500",
            "fax_number": "972-224-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH D.EBOLUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "OPALEYE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIR OF OPERATIONS",
        "authorized_official_telephone_number": "972-224-4500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "166130801",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "166130802",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166130801",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166130802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Assured Medical Equipment & Supplies",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Desoto, TX
• Providers in Desoto, 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 Nov 14, 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.