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Organization
ERNIES HOUSE
Active
Organization
ERNIES HOUSE
Active
Other names
Ernies Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERNEST PERCY MIMS JR. DME (OWNER OPERATOR)
(817) 386-3923
Entity
Organization
Contact information
Practice address
4321 MARTHA LN, FORT WORTH, TX 76103-2705
(817) 386-3923
(817) 386-3923
Mailing address
4321 MARTHA LN, FORT WORTH, TX 76103-2705
(817) 386-3923
(817) 386-3923
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
10/31/2008
Last updated
10/31/2008
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