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General NPI Number Information
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NPI Number | 1457508467
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Entity Type | Organization
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Legal Business Name | SAMCOOKE MEDICAL SUPPLIES, INC.
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Dates
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Enumeration Date | 08/20/2008
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Last Update Date | 09/01/2011
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Provider Practice Location Address
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Address Line | 6200 SAVOY DR STE 265
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City | HOUSTON
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State | TX
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Zip | 77036-3324
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Country | US
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Telephone | 713-291-1867
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Fax | 832-848-1481
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Provider Business Mailing Address
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Address Line | 2601 WOODLAND PARK DR APT 4110
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City | HOUSTON
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State | TX
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Zip | 77077-6166
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Country | US
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Telephone | 713-291-1867
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Fax |
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Authorized Official
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Title or Position | PRINCIPAL OFFICER
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Name | MR. NNANNA O OKORAFOR
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Credential |
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Telephone | 713-291-1867
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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 | 0074991
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License Number State | TX
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