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Organization
TRAVIS MEDICAL SALES CORPORATION
Active
Organization
TRAVIS MEDICAL SALES CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY MATUKEWICZ (SECRETARY)
(423) 756-2268
Entity
Organization
Contact information
Practice address
1724 SUNSET DR, SAN ANGELO, TX 76904-7104
(325) 223-6400
(325) 223-6404
Mailing address
5959 SHALLOWFORD RD STE 443, CHATTANOOGA, TN 37421-2245
(423) 756-2268
(423) 362-5413
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
NULL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
NULL
Other
Enumeration date
12/29/2009
Last updated
03/25/2021
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