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NPI Code Detail

MEDICARE: SUPPLY MEDICAL USA, LLC

MEDICARE: SUPPLY MEDICAL USA, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1568719383
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUPPLY MEDICAL USA, LLC
Provider Business Mailing Address
First Line : 4141 SOUTHWEST FWY STE 505B
Second Line :
City : HOUSTON
State : TX
Zip : 77027-7334
Country : US
Telephone Number : 713-366-6279
Fax Number : 713-960-1122
Provider Business Practice Location Address
First Line : 4141 SOUTHWEST FWY STE 505B
Second Line :
City : HOUSTON
State : TX
Zip : 77027-7334
Country : US
Telephone Number : 713-366-6279
Fax Number : 713-960-1122
Authorized Official
Title or Position : CEO/OWNER
Name : TERRELL EDWARD CARMON
Credential :
Telephone Number : 713-366-6279
Provider Enumeration Date : 08/10/2012
Last Update Date : 08/10/2012

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Directions to “SUPPLY MEDICAL USA, LLC ” Practice Location

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