| NPI | 1467603829 |
|---|---|
| Doing Business As | PROVIDACARE MEDICAL SUPPLY |
| Entity Type | Organization |
| Authorized Contact | RYAN N BENNETT CEO 512-733-6518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-10-03 |
| Last Update Date | 2014-01-22 |