# MED-DEPOT, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1497919419
- **Authorized official:** MR. CHARLES CLUTE (CEO)
- **Authorized official phone:** (214) 572-0520

## Contact information

- **Practice address:** 2478 FORT WORTH ST, GRAND PRAIRIE, TX 75050-4914
- **Practice address phone:** (972) 606-6336
- **Mailing address:** 2351 W NORTHWEST HWY, SUITE 2135, DALLAS, TX 75220-4433
- **Mailing address phone:** (214) 572-0520
- **Mailing address fax:** (214) 572-0511

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | — | NULL | — |

## Other

- **Enumeration date:** 07/18/2008
- **Last updated:** 07/18/2008