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NPI Code Detail

MEDICARE: CIDEL MEDICAL SUPPLIES INC.

MEDICARE: CIDEL MEDICAL SUPPLIES 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
1332BC3200XCustomized Equipment (DME)
2332BN1400XNursing Facility Supplies (DME)1000565TX
3332BX2000XOxygen Equipment & Supplies (DME)1000565TX
4332B00000XDurable Medical Equipment & Medical Supplies1000565TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11000565OTHERTXWHOLESALE DISTRIBUTOR LICENSE

General Provider Information

NPI Number : 1992092092
Entity Type Code : Organization
Provider Name (Legal Business Name) : CIDEL MEDICAL SUPPLIES INC.
Provider Business Mailing Address
First Line : 804 W SHORE DR
Second Line : SUITE 11
City : RICHARDSON
State : TX
Zip : 75080-5047
Country : US
Telephone Number : 972-801-7454
Fax Number :
Provider Business Practice Location Address
First Line : 804 W SHORE DR
Second Line : SUITE 11
City : RICHARDSON
State : TX
Zip : 75080-5047
Country : US
Telephone Number : 972-801-7454
Fax Number :
Authorized Official
Title or Position : C.E.O
Name : MR. EMMANUEL IKE IFEJI
Credential :
Telephone Number : 972-801-7454
Provider Enumeration Date : 07/09/2011
Last Update Date : 02/14/2024

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Directions to “CIDEL MEDICAL SUPPLIES INC. ” Practice Location

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