Provider Demographics
NPI:1124037031
Name:IZZY INC
Entity Type:Organization
Organization Name:IZZY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:DELL
Authorized Official - Last Name:ISBELL
Authorized Official - Suffix:
Authorized Official - Credentials:SECRETARY
Authorized Official - Phone:903-693-2923
Mailing Address - Street 1:106 N SHELBY ST
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:TX
Mailing Address - Zip Code:75633
Mailing Address - Country:US
Mailing Address - Phone:903-693-2923
Mailing Address - Fax:903-693-3931
Practice Address - Street 1:106 N SHELBY ST
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:TX
Practice Address - Zip Code:75633
Practice Address - Country:US
Practice Address - Phone:903-693-2923
Practice Address - Fax:903-693-3931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1625787OtherMEDICAID
TX4742090001Medicare ID - Type Unspecified