Organization
HOSPICE SUPPLY INC
Active
Other names
Lakeway Home Medical
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA G PETTY (SECRETARY TREASURER)
(575) 693-5303
Entity
Organization
Contact information
Practice address
1200 LAKEWAY DR STE 2, LAKEWAY, TX 78734-4467
(512) 263-5676
Mailing address
1905 COLONIAL PKWY, CLOVIS, NM 88101-3117
(575) 693-2665
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
14
TX
Other
Enumeration date
07/13/2006
Last updated
07/21/2022
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