Provider Demographics
NPI:1265817118
Name:ODYSSEY MANAGEMENT SUPPLIES LLC
Entity Type:Organization
Organization Name:ODYSSEY MANAGEMENT SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-945-2145
Mailing Address - Street 1:1846 SNAKE RIVER RD STE B
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-7758
Mailing Address - Country:US
Mailing Address - Phone:281-945-2145
Mailing Address - Fax:888-330-7541
Practice Address - Street 1:1846 SNAKE RIVER RD STE B
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-7758
Practice Address - Country:US
Practice Address - Phone:281-945-2145
Practice Address - Fax:888-330-7541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001580332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies