Provider Demographics
NPI:1235530940
Name:ELLETT MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:ELLETT MEDICAL SUPPLIES INC
Other - Org Name:ELLETT MEDICAL CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELLETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-501-3310
Mailing Address - Street 1:526 KINGWOOD DR
Mailing Address - Street 2:268
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-4473
Mailing Address - Country:US
Mailing Address - Phone:281-359-0576
Mailing Address - Fax:281-354-5222
Practice Address - Street 1:2011 RUNNING SPRINGS DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3116
Practice Address - Country:US
Practice Address - Phone:281-359-0576
Practice Address - Fax:281-654-5222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-12
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance