Provider Demographics
NPI:1861483778
Name:EDIFY DME
Entity type:Organization
Organization Name:EDIFY DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLEPROPRIETORSHIP
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-781-6530
Mailing Address - Street 1:1315 W POLK ST
Mailing Address - Street 2:SUITE 14
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-2135
Mailing Address - Country:US
Mailing Address - Phone:956-781-6530
Mailing Address - Fax:956-781-6539
Practice Address - Street 1:1315 W POLK ST
Practice Address - Street 2:SUITE 14
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-2135
Practice Address - Country:US
Practice Address - Phone:956-781-6530
Practice Address - Fax:956-781-6539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0082414332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5455390001Medicare ID - Type UnspecifiedDURABLE MEDICAL EQUIPMENT