PROVIDACARE MEDICAL SUPPLY LTD NPI 1700072824

NPI Information

PROVIDACARE MEDICAL SUPPLY LTD is an oxygen equipment and supplies durable medical equipment medical supplies in Austin, TX. PROVIDACARE MEDICAL SUPPLY LTD NPI is 1700072824. The provider is registered as an organization entity type.

The provider's business location address is:

3724 EXECUTIVE CENTER DR
SUITE 250
AUSTIN, TX
ZIP 78731-646
Phone: (512) 326-9898
Fax: (512) 326-9190

The provider's authorized official is Ryan N Bennett .
The authorized official title is Ceo and has the following contact phone number (512) 733-6518.

The enumeration date for this NPI number is 9/21/2007 and was last updated on 7/17/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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