# DR SUPPLY

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

## Provider details

- **NPI number:** 1669708996
- **Authorized official:** MR. DOUGLAS ROY PETERSON (OWNER/MANAGER)
- **Authorized official phone:** (817) 846-9502

## Contact information

- **Practice address:** 2601 COUNTY ROAD 415, CLEBURNE, TX 76031-9061
- **Practice address phone:** (817) 846-9502
- **Practice address fax:** (817) 645-4550
- **Mailing address:** 2601 COUNTY ROAD 415, CLEBURNE, TX 76031-9061
- **Mailing address phone:** (817) 846-9502
- **Mailing address fax:** (817) 645-4550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0091228 | TX | Yes |

## Other

- **Enumeration date:** 10/21/2009
- **Last updated:** 10/21/2009