Organization
AGI D M E INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL TOMAS ORELLANA (VICE PRESIDENT)
(210) 858-2040
Entity
Organization
Contact information
Practice address
15600 SAN PEDRO AVE, SUITE 203, SAN ANTONIO, TX 78232-3740
(210) 858-2040
Mailing address
15600 SAN PEDRO AVE, SUITE 203, SAN ANTONIO, TX 78232-3740
(210) 858-2040
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6392770001
MEDICARE PTAN
TX
Enumeration date
09/16/2008
Last updated
09/24/2014
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