NPIMap

Organization Active NPI

Healthline Medical Equipment LLC

  • Oxygen Equipment & Supplies (DME)
  • Wichita Falls, TX
National Provider Identifier
1962401620
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
0059074 Issued in TX
Legal business name
HEALTHLINE MEDICAL EQUIPMENT LLC
Practice address
4709 Lydia Dr
Wichita Falls, TX 76308-4537
Phone
(940) 318-0091
Fax
(940) 691-0757
NPI assigned
Jul 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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

Authorized official

Name
Wendy Russalesi
Title
Cco
Phone
(484) 246-9499

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 0037358 TX
Oxygen Equipment & Supplies (DME) 332BX2000X 0059074 TX Primary
Prosthetic/Orthotic Supplier 335E00000X

Addresses

Primary practice location

4709 Lydia Dr
Wichita Falls, TX 76308-4537

Mailing address

555 E North LN Ste 5075
Conshohocken, PA 19428-2490

Other identifiers 2

IdentifierTypeStateIssuer
016165501MedicaidTX
087415801MedicaidTX

Other names 1

  • Healthline Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930064753 TX DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & Equipment 1254459316 Practice locations: Wichita Falls, TX

Other NPIs with the same Medicare PAC ID 12

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
A M Home Diagnostics in15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784764800000",
    "number": "1962401620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 E NORTH LN STE 5075",
            "city": "CONSHOHOCKEN",
            "state": "PA",
            "postal_code": "194282490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4709 LYDIA DR",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763084537",
            "telephone_number": "940-318-0091",
            "fax_number": "940-691-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHLINE MEDICAL EQUIPMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A",
        "authorized_official_last_name": "RUSSALESI",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "CCO",
        "authorized_official_telephone_number": "484-246-9499"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TX",
            "license": "0037358",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "TX",
            "license": "0059074",
            "primary": true
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016165501",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087415801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthline",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healthline",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.