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General NPI Number Information
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NPI Number | 1427288448
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Entity Type | Organization
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Legal Business Name | CIPAN MEDICAL SUPPLY
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Dates
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Enumeration Date | 07/24/2009
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 818 S CENTRAL EXPY STE 4
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City | RICHARDSON
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State | TX
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Zip | 75080-7306
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Country | US
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Telephone | 972-699-8400
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Fax | 972-699-8408
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Provider Business Mailing Address
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Address Line | 818 S CENTRAL EXPY STE 4
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City | RICHARDSON
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State | TX
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Zip | 75080-7306
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Country | US
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Telephone | 972-699-8400
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Fax | 972-699-8408
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Authorized Official
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Title or Position | OWNER
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Name | CHINYELU NNAKE
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Credential |
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Telephone | 972-699-8400
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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 | 1000123
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License Number State | TX
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