Provider Demographics
NPI:1164668109
Name:AMA ULTIMATE MEDICAL SUPPLY
Entity Type:Organization
Organization Name:AMA ULTIMATE MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMAETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:OKON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-261-1259
Mailing Address - Street 1:2440 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-5522
Mailing Address - Country:US
Mailing Address - Phone:281-261-1259
Mailing Address - Fax:281-261-1263
Practice Address - Street 1:2440 S MAIN ST
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-5522
Practice Address - Country:US
Practice Address - Phone:281-261-1259
Practice Address - Fax:281-261-1263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies