Organization
HORNS MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY WAYNE HORN (VICE PRESIDENT)
(903) 675-9360
Entity
Organization
Contact information
Practice address
1901 S PALESTINE ST, ATHENS, TX 75751-5701
(903) 675-9360
(903) 675-1570
Mailing address
1901 S PALESTINE ST, ATHENS, TX 75751-5701
(903) 675-9360
(903) 675-1570
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
2844334
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
0040665
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0056656
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010918301
—
TX
05
—
010918303
—
TX
05
—
016823901
—
TX
01
—
530830
BCBS NUMBER
TX
Enumeration date
07/12/2006
Last updated
02/11/2013
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