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NPI Code Detail

MEDICARE: SAR MEDICAL SUPPLY INC

MEDICARE: SAR MEDICAL SUPPLY INC
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 Supplies0102081TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790952679
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAR MEDICAL SUPPLY INC
Provider Business Mailing Address
First Line : 2351 W NORTHWEST HWY
Second Line : SUITE 3245
City : DALLAS
State : TX
Zip : 75220-4433
Country : US
Telephone Number : 214-357-8100
Fax Number : 214-594-6894
Provider Business Practice Location Address
First Line : 2351 W NORTHWEST HWY
Second Line : SUITE 3245
City : DALLAS
State : TX
Zip : 75220-4433
Country : US
Telephone Number : 214-357-8100
Fax Number : 214-594-6894
Authorized Official
Title or Position : PRESIDENT
Name : DR. AYO O OGUNDELE
Credential : PHD
Telephone Number : 214-357-8100
Provider Enumeration Date : 05/10/2008
Last Update Date : 06/13/2011

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Directions to “SAR MEDICAL SUPPLY INC ” Practice Location

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