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General NPI Number Information
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NPI Number | 1457380560
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Entity Type | Organization
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Legal Business Name | EMPIRE MEDICAL SUPPLY INC
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13955 MURPHY RD SUITE 205
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City | STAFFORD
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State | TX
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Zip | 77477-4920
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Country | US
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Telephone | 281-403-2595
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Fax | 281-403-2624
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Provider Business Mailing Address
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Address Line | PO BOX 2546
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City | STAFFORD
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State | TX
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Zip | 77497-2546
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Country | US
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Telephone | 281-403-2595
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Fax | 281-403-2624
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. ENOBONG I EDWARD
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Credential |
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Telephone | 281-403-2595
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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 | 0062812
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License Number State | TX
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