MEDICARE: A-ONE MEDICAL SUPPLIES 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	332BD1200X	Dialysis Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1972112258
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A-ONE MEDICAL SUPPLIES LLC

Provider Business Mailing Address
First Line	:	17119 RED OAK DR UNIT 73223
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77273-4412
Country	:	US
Telephone Number	:	832-890-8555
Fax Number	:	281-919-1378

Provider Business Practice Location Address
First Line	:	4201 CYPRESS CREEK PKWY STE 165
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77068-3457
Country	:	US
Telephone Number	:	832-890-8555
Fax Number	:	281-919-1128

Authorized Official
Title or Position	:	OWNER
Name	:	MS. DAPHNE DENISE GILES
Credential	:
Telephone Number	:	832-890-8555

Provider Enumeration Date	:	07/23/2020
Last Update Date	:	07/23/2020

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Directions to “A-ONE MEDICAL SUPPLIES LLC ” Practice Location

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