# EXECUTIVE HEALTHCARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Allied Tri-Med
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205173481
- **Authorized official:** MR. CHANDLER JACKSON (V.P)
- **Authorized official phone:** (972) 432-6550

## Contact information

- **Practice address:** 6303 FOREST PARK RD, SUITE BLA 126, DALLAS, TX 75235
- **Practice address phone:** (972) 432-6550
- **Practice address fax:** (214) 261-2217
- **Mailing address:** 6303 FOREST PARK RD, SUITE BLA 126, DALLAS, TX 75235
- **Mailing address phone:** (972) 432-6550
- **Mailing address fax:** (214) 261-2217

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 01/09/2013
- **Last updated:** 01/09/2013