Provider Demographics
NPI:1730523507
Name:ARBOR MEDICAL EQUIPMENT, INC.
Entity type:Organization
Organization Name:ARBOR MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CALICOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-741-4331
Mailing Address - Street 1:11477 WOODLAND SPRINGS DR
Mailing Address - Street 2:STE 130
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-7132
Mailing Address - Country:US
Mailing Address - Phone:817-741-4331
Mailing Address - Fax:817-741-4559
Practice Address - Street 1:11477 WOODLAND SPRINGS DR
Practice Address - Street 2:STE 130
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-7132
Practice Address - Country:US
Practice Address - Phone:817-741-4331
Practice Address - Fax:817-741-4559
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARBOR MEDICAL EQUIPMENT, INC. GRANBURY, TX
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-24
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001019332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4895400002Medicare NSC