Provider Demographics
NPI:1053416933
Name:AABCO MEDICAL, INC.
Entity type:Organization
Organization Name:AABCO MEDICAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:K
Authorized Official - Last Name:LUTTRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-439-1118
Mailing Address - Street 1:PO BOX 2104
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75483-2104
Mailing Address - Country:US
Mailing Address - Phone:903-439-1118
Mailing Address - Fax:903-885-4721
Practice Address - Street 1:582 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482-2008
Practice Address - Country:US
Practice Address - Phone:903-439-1118
Practice Address - Fax:903-885-4721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20865332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0000530138OtherBC/BS PROVIDER
TX0000530138OtherBC/BS PROVIDER