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General NPI Number Information
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NPI Number | 1346355997
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Entity Type | Organization
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Legal Business Name | ABC MEDICAL MART & SCRUBS
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 04/17/2008
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Provider Practice Location Address
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Address Line | 5622 GARTH ROAD
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City | BAYTOWN
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State | TX
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Zip | 77521-9626
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Country | US
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Telephone | 281-421-8740
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Fax | 281-421-8741
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Provider Business Mailing Address
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Address Line | 5622 GARTH RD
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City | BAYTOWN
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State | TX
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Zip | 77521-9626
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Country | US
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Telephone | 281-421-8740
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Fax | 281-421-8741
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SUSAN ANN PERRY-MONROE
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Credential | RN
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Telephone | 281-424-9600
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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 | 0077860
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License Number State | TX
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