MEDICARE: REALMED SUPPLY LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332BX2000X	Oxygen Equipment & Supplies (DME)
2	335E00000X	Prosthetic/Orthotic Supplier
3	332BD1200X	Dialysis Equipment & Supplies (DME)
4	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1265387856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REALMED SUPPLY LLC

Provider Business Mailing Address
First Line	:	25807 WESTHEIMER PKWY STE 351
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-5370
Country	:	US
Telephone Number	:	346-586-4493
Fax Number	:	346-396-2256

Provider Business Practice Location Address
First Line	:	25807 WESTHEIMER PKWY STE 351
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-5370
Country	:	US
Telephone Number	:	346-586-4493
Fax Number	:	346-396-2256

Authorized Official
Title or Position	:	OWNER
Name	:	HANIF M GHANCHI
Credential	:	OWNER
Telephone Number	:	832-908-7776

Provider Enumeration Date	:	02/28/2026
Last Update Date	:	04/27/2026

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