| NPI | 1073506457 |
|---|---|
| Doing Business As | PROVIDENCE MEDICAL EQUIPMENT |
| Entity Type | Organization |
| Authorized Contact | KENT KEAHEY CEO 254-751-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: TX 000111) |
| Enumeration Date | 2005-08-31 |
| Last Update Date | 2012-01-26 |