Brilliant Medical Boutique Llc
Durable Medical Equipment & Medical Supplies
925 Santa Fe Dr, Suite 100, Weatherford
Texas, 76086-5866
817-594-5868 817-594-5833
Brilliant Medical Boutique Llc is a Durable Medical Equipment & Medical Supplies in Weatherford, Texas. It is located at 925 Santa Fe Dr, Suite 100, Weatherford and it's customer support contact number is 817-594-5868. The authorized person of Brilliant Medical Boutique Llc is Jamie B. Mittendorf who is Owner And Operator of this DME and his contact number is 817-594-5868. Brilliant Medical Boutique Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Brilliant Medical Boutique Llc is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.
DME Supplier Details:
Brilliant Medical Boutique Llc type, location, contact phone number and fax are as below. Patients can directly walkin or can call on the below given customer support phone number for enquiries.
| Name: | Brilliant Medical Boutique Llc |
| Type: | Durable Medical Equipment & Medical Supplies |
| Location: | 925 Santa Fe Dr, Suite 100, Weatherford,
Texas, 76086-5866 |
| Phone: | 817-594-5868 |
| Fax: | 817-594-5833 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this supplier is as below. Person's position and contact details are also mentioned below.
| Name: | Jamie B. Mittendorf |
| Position: | Owner And Operator |
| Contact Number: | 817-594-5868 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given supplier are as mentioned below.
| NPI Number: | 1497793830 |
| NPI Enumeration Date: | 04 Jun, 2006 |
| NPI Last Update On: | 08 Sep, 2022 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Brilliant Medical Boutique Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Durable Medical Equipment & Medical Supplies | | | Primary | |
| Prosthetic/orthotic Supplier | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of this supplier such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 178601402 | Medicaid | Texas | |
Medicare Enrollment:
Brilliant Medical Boutique Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 1254533656 | O20100930008676 | Brilliant Medical Boutique Llc | DME SUPPLIER - MEDICAL SUPPLY COMPANY |
Products Available:
Brilliant Medical Boutique Llc has following products available for sale under medicare.
| Products: |
|---|
| • Breast Prostheses & Accessories | • Canes & Crutches |
| • Commodes, Urinals, & Bedpans | • Diabetic Shoes & Inserts: Prefabricated |
| • Nebulizer Equipment & Supplies | • Ostomy Supplies |
| • Pneumatic Compression Devices | • Power Operated Vehicles (scooters) |
| • Seat Lift Mechanisms | • Surgical Dressings |
| • Traction Equipment | • Transcutaneous Electrical Nerve Stimulators (tens) Units |
| • Urological Supplies | • Walkers |
| • Wheelchair Seating/cushions | • Wheelchairs & Accessories: Standard Manual |
| • Wheelchairs & Accessories: Standard Power | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 925 Santa Fe Dr, Suite 100
Weatherford, Texas |
| Zip: | 76086-5866 |
| Phone Number: | 817-594-5868 |
| Fax Number: | 817-594-5833 |
Patients can reach Brilliant Medical Boutique Llc at
925 Santa Fe Dr, Suite 100, Weatherford, Texas or can
call on customer care at 817-594-5868.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 13 July, 2026.