Provider Demographics
NPI:1174513295
Name:ARBOR MEDICAL EQUIPMENT, INC
Entity type:Organization
Organization Name:ARBOR MEDICAL EQUIPMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-326-2325
Mailing Address - Street 1:5310 ACTON HWY
Mailing Address - Street 2:STE 102
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76049-3105
Mailing Address - Country:US
Mailing Address - Phone:817-326-2325
Mailing Address - Fax:817-326-2327
Practice Address - Street 1:5310 ACTON HWY
Practice Address - Street 2:STE 102
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76049-3105
Practice Address - Country:US
Practice Address - Phone:817-326-2325
Practice Address - Fax:817-326-2327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0071214332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167533202Medicaid
TX4895400001Medicare ID - Type Unspecified