Organization
PAIGE I, INC
Active
Other names
Beaumont Medical Specialties
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA COLEMAN (PRESIDENT)
(409) 832-0303
Entity
Organization
Contact information
Practice address
3150 MEDICAL CENTER DR STE 3, BEAUMONT, TX 77701-4651
(409) 832-0303
(409) 832-0802
Mailing address
PO BOX 785, BEAUMONT, TX 77704
(409) 832-0303
(409) 832-0802
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0089200
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011452201
—
TX
05
—
091374101
—
TX
01
—
519281
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
07/08/2006
Last updated
03/23/2010
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