Provider Demographics
NPI:1073665246
Name:HALLMARK MEDICAL SUPPLIES & EQUIPMENT
Entity Type:Organization
Organization Name:HALLMARK MEDICAL SUPPLIES & EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNEDY
Authorized Official - Middle Name:UGOCHUKWU
Authorized Official - Last Name:NDUKWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-324-4656
Mailing Address - Street 1:8035 E R L THORNTON FRWY
Mailing Address - Street 2:SUITE 119
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-5531
Mailing Address - Country:US
Mailing Address - Phone:214-324-4656
Mailing Address - Fax:214-279-0093
Practice Address - Street 1:8035 E R L THORNTON FWY
Practice Address - Street 2:SUITE 119
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-5531
Practice Address - Country:US
Practice Address - Phone:214-324-4656
Practice Address - Fax:214-279-0093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0092331332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187734202Medicaid
TX187734201Medicaid
TX187734202Medicaid