MEDICARE: CIMOIC COMPANY INC

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	00526527	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235192931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CIMOIC COMPANY INC

Provider Business Mailing Address
First Line	:	PO BOX 2241
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-8241
Country	:	US
Telephone Number	:	214-217-0147
Fax Number	:	214-357-5737

Provider Business Practice Location Address
First Line	:	3160 COMMONWEALTH DR
Second Line	:	SUITE 190
City	:	DALLAS
State	:	TX
Zip	:	75247-6224
Country	:	US
Telephone Number	:	214-217-0147
Fax Number	:	214-357-5737

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. OBIE MBAKWE
Credential	:
Telephone Number	:	214-217-0147

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	01/31/2011

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Directions to “CIMOIC COMPANY INC ” Practice Location

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