Organization
ELIZABETH D.EBOLUM
Active
Other names
Assured Medical Equipment & Supplies
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH D OPALEYE RN (DIR OF OPERATIONS)
(972) 224-4500
Entity
Organization
Contact information
Practice address
1704 N HAMPTON RD, STE 207, DESOTO, TX 75115-8623
(972) 224-4500
(972) 224-4501
Mailing address
1704 N HAMPTON RD, STE 207, DESOTO, TX 75115-8623
(972) 224-4500
(972) 224-4501
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
166130801
TX
332B00000X
Durable Medical Equipment & Medical Supplies
166130802
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166130801
—
TX
05
—
166130802
—
TX
Enumeration date
10/25/2006
Last updated
11/14/2008
Update your record
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