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General NPI Number Information
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NPI Number | 1124245105
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Entity Type | Organization
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Legal Business Name | STAFFORD MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 4645 HIGHWAY 90A
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City | STAFFORD
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State | TX
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Zip | 77477-4726
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Country | US
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Telephone | 281-277-0452
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Fax | 281-277-0453
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Provider Business Mailing Address
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Address Line | 4645 HIGHWAY 90A
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City | STAFFORD
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State | TX
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Zip | 77477-4726
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Country | US
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Telephone | 281-277-0452
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Fax | 281-277-0453
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ALBERT IWOBI
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Credential |
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Telephone | 281-277-0452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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