Provider Demographics
NPI:1235192931
Name:CIMOIC COMPANY INC
Entity Type:Organization
Organization Name:CIMOIC COMPANY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MBAKWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-217-0147
Mailing Address - Street 1:PO BOX 2241
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-8241
Mailing Address - Country:US
Mailing Address - Phone:214-217-0147
Mailing Address - Fax:214-357-5737
Practice Address - Street 1:3160 COMMONWEALTH DR
Practice Address - Street 2:SUITE 190
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-6224
Practice Address - Country:US
Practice Address - Phone:214-217-0147
Practice Address - Fax:214-357-5737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00526527332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147168201Medicaid
TX147168201Medicaid