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General NPI Number Information
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NPI Number | 1114973252
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Entity Type | Organization
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Legal Business Name | FIRST STATE MEDICAL SUPPLY COMPANY
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 305 E JACKSON ST SUITE 109
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City | HARLINGEN
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State | TX
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Zip | 78550-6888
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Country | US
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Telephone | 956-428-3313
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Fax | 956-428-3397
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Provider Business Mailing Address
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Address Line | 305 E JACKSON ST SUITE 109
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City | HARLINGEN
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State | TX
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Zip | 78550-6888
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Country | US
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Telephone | 956-428-3313
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Fax | 958-428-3397
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DR. OKEZIE J.M. UBI JR.
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Credential | PHARM D
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Telephone | 956-428-3313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 0066891
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License Number State | TX
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