MEDICARE: NICHE MEDICAL SALES 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	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1891874640
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NICHE MEDICAL SALES INC

Provider Business Mailing Address
First Line	:	7066 LAKEVIEW HAVEN DR
Second Line	:	SUITE 125B
City	:	HOUSTON
State	:	TX
Zip	:	77095-2568
Country	:	US
Telephone Number	:	281-463-4113
Fax Number	:	281-463-4033

Provider Business Practice Location Address
First Line	:	7066 LAKEVIEW HAVEN DR
Second Line	:	SUITE 125B
City	:	HOUSTON
State	:	TX
Zip	:	77095-2568
Country	:	US
Telephone Number	:	281-463-4113
Fax Number	:	281-463-4033

Authorized Official
Title or Position	:	OWNER
Name	:	KENLYN DEROCHE OJONTA
Credential	:
Telephone Number	:	281-463-4113

Provider Enumeration Date	:	11/03/2006
Last Update Date	:	10/21/2014

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Directions to “NICHE MEDICAL SALES INC ” Practice Location

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