Healthcare Provider Details

I. General information

NPI: 1952104937
Provider Name (Legal Business Name): SOUTH MED SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 N LAKE FOREST DR APT 2117
MCKINNEY TX
75071
US

IV. Provider business mailing address

2770 N LAKE FOREST DR APT 2117
MCKINNEY TX
75071
US

V. Phone/Fax

Practice location:
  • Phone: 972-375-4568
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: FARHANA MAZHAR
Title or Position: OWNER
Credential:
Phone: 972-375-4568