# SCOOTER MART INC

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

## Provider details

- **NPI number:** 1568464584
- **Authorized official:** MR. KENNETH W SONGER LUTCF (VP)
- **Authorized official phone:** (254) 629-2416

## Contact information

- **Practice address:** 208 S LAMAR ST, EASTLAND, TX 76448-2712
- **Practice address phone:** (254) 629-2416
- **Practice address fax:** (254) 629-0998
- **Mailing address:** 208 S LAMAR ST, EASTLAND, TX 76448-2712
- **Mailing address phone:** (254) 629-2416
- **Mailing address fax:** (254) 629-0998

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0041085 | TX | Yes |

## Other

- **Enumeration date:** 08/10/2005
- **Last updated:** 08/22/2020