MEDICARE: COMPANION CARE MEDICAL SUPPLY LLC

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

General Provider Information

NPI Number	:	1225911951
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPANION CARE MEDICAL SUPPLY LLC

Provider Business Mailing Address
First Line	:	5125 ELLA BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-1309
Country	:	US
Telephone Number	:	512-402-7776
Fax Number	:

Provider Business Practice Location Address
First Line	:	5125 ELLA BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-1309
Country	:	US
Telephone Number	:	512-402-7776
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	SADDAM MUSHTAQUE
Credential	:
Telephone Number	:	512-402-7776

Provider Enumeration Date	:	07/29/2025
Last Update Date	:	10/16/2025

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