Organization
ACTIVMEDICAL DENTON, INC
Active
Other names
ActivMedical
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES BEALL GARNER (PRESIDENT)
(940) 484-0228
Entity
Organization
Contact information
Practice address
2317 W UNIVERSITY DR, SUITE 101, DENTON, TX 76201-1600
(940) 484-0228
(940) 484-0766
Mailing address
2317 W UNIVERSITY DR, SUITE 101, DENTON, TX 76201-1600
(940) 484-0228
(940) 484-0766
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0030874
TX
332BC3200X
Customized Equipment (DME)
0030874
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0030874
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
0030874
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136319-01
—
TX
05
—
079217801
—
TX
01
—
10007096
AMERIGROUP
TX
05
—
108415401
—
TX
01
—
505306
BCBS
TX
01
—
517284
HMO BLUE ORTHO AND PROS
TX
Enumeration date
09/07/2005
Last updated
04/11/2019
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