# RUSSELL MEDICAL INC

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

## Provider details

- **NPI number:** 1578517488
- **Authorized official:** MRS. DEBRA L RUSSELL (PRESIDENT)
- **Authorized official phone:** (361) 808-7382

## Contact information

- **Practice address:** 4410 DILLON LN, SUITE 17, CORPUS CHRISTI, TX 78415-5335
- **Practice address phone:** (361) 808-7382
- **Practice address fax:** (361) 808-7367
- **Mailing address:** 4410 DILLON LN, SUITE 17, CORPUS CHRISTI, TX 78415-5335
- **Mailing address phone:** (361) 808-7382
- **Mailing address fax:** (361) 808-7367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171W00000X | Contractor | — | NULL | — |
| 171W00000X | Contractor | — | — | — |
| 171WH0202X | Home Modifications Contractor | — | NULL | — |
| 171WH0202X | Home Modifications Contractor | — | — | — |
| 171WV0202X | Vehicle Modifications Contractor | — | NULL | — |
| 171WV0202X | Vehicle Modifications Contractor | — | — | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0041403 | TX | Yes |
| 332BC3200X | Customized Equipment (DME) | 0041403 | TX | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | 0041403 | TX | — |

## Other

- **Enumeration date:** 05/22/2006
- **Last updated:** 09/14/2016