Organization
PALM GROVE MEDICAL SUPPLY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA GROVE (REGISTERED AGENT)
(956) 832-4468
Entity
Organization
Contact information
Practice address
44 W JEFFERSON ST STE C, BROWNSVILLE, TX 78520-6259
(956) 544-7256
Mailing address
44 W JEFFERSON ST STE C, BROWNSVILLE, TX 78520-6259
(956) 544-7256
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183591001
—
TX
05
—
183591002
—
TX
Enumeration date
08/30/2006
Last updated
05/29/2008
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