Organization
GREAT AMERICAN SCOOTER COMPANY GOLDEN TRIANGLE LLC
Active
Other names
Great American Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BOBBY W SANDERS (OWNER)
(409) 833-8300
Entity
Organization
Contact information
Practice address
65 N 11TH ST, BEAUMONT, TX 77702-2224
(409) 833-8300
(409) 833-8301
Mailing address
65 N 11TH ST, BEAUMONT, TX 77702-2224
(409) 833-8300
(409) 833-8301
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159927601
—
TX
05
—
159927602
—
TX
01
—
531789
BLUE CROSS BLUE SHIELD
TX
Enumeration date
09/28/2006
Last updated
01/31/2012
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