Provider Demographics
NPI:1235901752
Name:MASVIDA HEALTH CARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:MASVIDA HEALTH CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITELEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-704-3103
Mailing Address - Street 1:133 NURSERY LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76114-4334
Mailing Address - Country:US
Mailing Address - Phone:817-704-3103
Mailing Address - Fax:
Practice Address - Street 1:2021 S NICKLAS AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73128-3010
Practice Address - Country:US
Practice Address - Phone:682-371-9996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASVIDA HEALTH CARE SOLUTIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-27
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies