Provider Demographics
NPI:1093741068
Name:ROSEMARY ADELAJA
Entity Type:Organization
Organization Name:ROSEMARY ADELAJA
Other - Org Name:ABITOL MICRO-MED SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADELAJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-221-7155
Mailing Address - Street 1:10935 ESTATE LANE
Mailing Address - Street 2:STE S330
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-2316
Mailing Address - Country:US
Mailing Address - Phone:214-221-7155
Mailing Address - Fax:214-221-7275
Practice Address - Street 1:10935 ESTATE LN
Practice Address - Street 2:STE S330
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-2316
Practice Address - Country:US
Practice Address - Phone:214-221-7155
Practice Address - Fax:214-221-7275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-23
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX184471401Medicaid
TX184471402Medicaid
TX5737670001Medicare NSC