Provider Demographics
NPI:1144741430
Name:DOUGLAS HEALTH SUPPLIES
Entity Type:Organization
Organization Name:DOUGLAS HEALTH SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MUBASHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:TAHIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-385-5931
Mailing Address - Street 1:1299 FARNAM ST STE 300
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-1857
Mailing Address - Country:US
Mailing Address - Phone:402-385-5931
Mailing Address - Fax:
Practice Address - Street 1:1299 FARNAM ST STE 300
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-1857
Practice Address - Country:US
Practice Address - Phone:402-385-5931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies