Provider Demographics
NPI:1255660585
Name:ASSURANT MEDICAL SUPPLY
Entity Type:Organization
Organization Name:ASSURANT MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:DME
Authorized Official - Phone:214-753-6721
Mailing Address - Street 1:8035 E. RL THORNTON FRWY STE 420
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228
Mailing Address - Country:US
Mailing Address - Phone:214-753-6721
Mailing Address - Fax:214-327-5903
Practice Address - Street 1:1114 GERMANY DRIVE
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104
Practice Address - Country:US
Practice Address - Phone:214-753-6721
Practice Address - Fax:214-327-5903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies