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Organization

RUSSELL MEDICAL INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DEBRA L RUSSELL (PRESIDENT)
(361) 808-7382
Entity
Organization

Contact information

Practice address
4410 DILLON LN, SUITE 17, CORPUS CHRISTI, TX 78415-5335
(361) 808-7382
(361) 808-7367
Mailing address
4410 DILLON LN, SUITE 17, CORPUS CHRISTI, TX 78415-5335
(361) 808-7382
(361) 808-7367

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
171WH0202X
Home Modifications Contractor
171WV0202X
Vehicle Modifications Contractor
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0041403
TX
332BC3200X
Customized Equipment (DME)
0041403
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0041403
TX

Other

Enumeration date
05/22/2006
Last updated
09/14/2016
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