Organization
AMERICORF,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REVELL EDWARD HICKS JR. RRT, MBA (PRESIDENT)
(877) 822-2256
Entity
Organization
Contact information
Practice address
2312 COMANCHE TRL, GRAND PRAIRIE, TX 75052-8595
(877) 822-2256
Mailing address
2312 COMANCHE TRL, GRAND PRAIRIE, TX 75052-8595
(877) 822-2256
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
50966
TX
Other
Enumeration date
10/11/2007
Last updated
10/11/2007
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