Provider Demographics
NPI:1194827261
Name:ADORABLE MEDICAL SUPPLY INC.
Entity Type:Organization
Organization Name:ADORABLE MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-814-9931
Mailing Address - Street 1:1959 SARATOGA BLVD
Mailing Address - Street 2:3104
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78417-3415
Mailing Address - Country:US
Mailing Address - Phone:361-814-9931
Mailing Address - Fax:361-814-9932
Practice Address - Street 1:1959 SARATOGA BLVD
Practice Address - Street 2:3104
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78417-3415
Practice Address - Country:US
Practice Address - Phone:361-814-9931
Practice Address - Fax:361-814-9932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5784800001Medicare NSC