Provider Demographics
NPI:1023207008
Name:MOTION AND MOVEMENT MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:MOTION AND MOVEMENT MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-223-8896
Mailing Address - Street 1:1125 N ROBISON RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75501-4103
Mailing Address - Country:US
Mailing Address - Phone:903-223-8896
Mailing Address - Fax:903-832-2870
Practice Address - Street 1:1125 N ROBISON RD
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75501-4103
Practice Address - Country:US
Practice Address - Phone:903-223-8896
Practice Address - Fax:903-832-2870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6084550001Medicare NSC