MEDICARE: ANIMOS MEDICAL SUPPLY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	11083939	TX

General Provider Information

NPI Number	:	1073610077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANIMOS MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	2639 WALNUT HILL LN
Second Line	:	158
City	:	DALLAS
State	:	TX
Zip	:	75229-5640
Country	:	US
Telephone Number	:	214-352-6089
Fax Number	:	214-350-2190

Provider Business Practice Location Address
First Line	:	2639 WALNUT HILL LN
Second Line	:	158
City	:	DALLAS
State	:	TX
Zip	:	75229-5640
Country	:	US
Telephone Number	:	214-352-6089
Fax Number	:	214-350-2190

Authorized Official
Title or Position	:	OWNER
Name	:	PATIENCE IKEMEFUNA
Credential	:
Telephone Number	:	214-352-6089

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/22/2020

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Directions to “ANIMOS MEDICAL SUPPLY ” Practice Location

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