MEDICARE: SUPPLIES ON DEMAND 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	:	1932055621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUPPLIES ON DEMAND LLC

Provider Business Mailing Address
First Line	:	5473 BLAIR RD STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-4227
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2663 S LANCASTER RD #304
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75216
Country	:	US
Telephone Number	:	305-788-0000
Fax Number	:

Authorized Official
Title or Position	:	VP
Name	:	BRANDON RICHARDSON
Credential	:
Telephone Number	:	305-788-0000

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/06/2026

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