Provider Demographics
NPI:1245238138
Name:KMA MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:KMA MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:KOSHIE
Authorized Official - Last Name:ARTHUR
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:713-772-7070
Mailing Address - Street 1:9623 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1332
Mailing Address - Country:US
Mailing Address - Phone:713-772-7070
Mailing Address - Fax:713-772-7017
Practice Address - Street 1:9623 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1332
Practice Address - Country:US
Practice Address - Phone:713-772-7070
Practice Address - Fax:713-772-7017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-13
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTDH 0062868332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
531657OtherBLUE CROSS,BLUE SHIELD,TX
TX172243-02/172243-01Medicaid
TX5115440001Medicare NSC