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General NPI Number Information
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NPI Number | 1871317057
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Entity Type | Organization
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Legal Business Name | SMG SUPPLIES LLC
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Dates
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Enumeration Date | 11/13/2024
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 9304 FOREST LN # S212
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City | DALLAS
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State | TX
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Zip | 75243-6238
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Country | US
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Telephone | 214-377-9760
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Fax |
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Provider Business Mailing Address
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Address Line | 9304 FOREST LN STE S212
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City | DALLAS
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State | TX
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Zip | 75243-6238
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | WISLER ISME
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Credential |
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Telephone | 214-377-9760
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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 |
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License Number State |
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