Organization
ERNIES HOUSE
Active
Other names
Ernies Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERNEST PERCY MIMS JR. DME (OWNER OPERATOR)
(817) 386-3923
Entity
Organization
Contact information
Practice address
4321 MARTHA LN, FORT WORTH, TX 76103-2705
(817) 386-3923
(817) 386-3923
Mailing address
4321 MARTHA LN, FORT WORTH, TX 76103-2705
(817) 386-3923
(817) 386-3923
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
10/31/2008
Last updated
10/31/2008
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