Organization
ACTIVE AMERICAN SCOOTER CO.
Active
Other names
Active American Mobility and Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
SOLOMON LOWELL ADAMS (VICE PRESIDENT)
(979) 709-9521
Entity
Organization
Contact information
Practice address
13003 MURPHY RD, SUITE G1, STAFFORD, TX 77477-3956
(281) 495-4400
(281) 495-4401
Mailing address
13003 MURPHY RD, SUITE G1, STAFFORD, TX 77477-3956
(281) 495-4400
(281) 495-4401
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
189000601
—
TX
05
—
189000602
—
TX
Enumeration date
08/19/2006
Last updated
01/27/2010
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