Acg Medical Supply Incorporated

Organization Active NPI Durable Medical Equipment & Medical Supplies · Rowlett, TX

NPI 1972506350 · NPPES record last updated Dec 8, 2021

Key facts

NPI
1972506350
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
License
0040125 (TX)
Legal business name
ACG MEDICAL SUPPLY INCORPORATED
Practice address
3502A Lakeview Pkwy
Rowlett, TX 75088-4005
Phone
(972) 463-0737
Fax
(972) 463-0920
NPI assigned
May 31, 2005
Organization subpart
No

Authorized official

Name
Mr. David Gary Gampher
Title
President
Phone
(972) 463-0737

Other NPIs with the same Medicare PAC ID 2

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

Corporate family (same tax ID) 2

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

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Acg Medical Supply Inc
3502 Lakeview Pkwy, Rowlett, TX 75088-4005 · (972) 463-0737
Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Hospital Beds (Electric)|Hospital Beds (Manual)|Support Surfaces: Pressure Reducing Beds/Mats/Pads|Traction Equipment|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Canes and/or … Does not accept assignment
Participating since Apr 29, 1999

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930003275 TX DME Supplier - Medical Supply Company 1759402266 Practice locations: Rowlett, TX

National Provider Directory

Tax ID family
Acg Medical Supply Incorporated (3 organizations share this tax ID)

Locations

3502A Lakeview Pkwy
Rowlett, TX 75088
Phone (972) 463-0737

3502 Lakeview Pkwy
#A
Rowlett, TX 75088
Phone (972) 463-0737

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0040125 TX Yes

Addresses

Primary practice location

3502A Lakeview Pkwy
Rowlett, TX 75088-4005

Mailing address

3502 Lakeview Pkwy
Suite a
Rowlett, TX 75088-4005
Phone (972) 463-0737

Other identifiers

IdentifierTypeStateIssuer
160948901MedicaidTX
160949701MedicaidTX
530962OtherTXBLUE CROSS BLUE SHIELD

Other providers in Rowlett, TX

All providers in Rowlett, TX · Durable Medical Equipment & Medical Supplies in Texas

Sources for this page

Verify at the official NPI Registry.