Provider Demographics
NPI:1225360225
Name:ABBY MEDICAL SUPPLY
Entity Type:Organization
Organization Name:ABBY MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KELECHI
Authorized Official - Middle Name:N
Authorized Official - Last Name:JOSEPHS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-266-5216
Mailing Address - Street 1:4931 AUTUMN HL
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-2445
Mailing Address - Country:US
Mailing Address - Phone:972-266-5216
Mailing Address - Fax:972-266-5216
Practice Address - Street 1:4931 AUTUMN HL
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-2445
Practice Address - Country:US
Practice Address - Phone:972-266-5216
Practice Address - Fax:972-266-5216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health