Organization
CROWN MEDICAL COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BOBBY ROYCE LOGAN RRT NPS RPSGT (MANAGER)
(806) 780-2642
Entity
Organization
Contact information
Practice address
517 82ND ST, LUBBOCK, TX 79404-6337
(806) 780-2642
(806) 780-5055
Mailing address
PO BOX 3987, LUBBOCK, TX 79452-3987
(806) 780-2642
(806) 780-5055
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0034595
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515187
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/05/2007
Last updated
03/28/2008
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