Provider Demographics
NPI:1306003397
Name:LOGISTICS MEDICAL EQUIPMENT & SUPPLIES, INC
Entity Type:Organization
Organization Name:LOGISTICS MEDICAL EQUIPMENT & SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:O
Authorized Official - Last Name:EZURUIKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-374-9995
Mailing Address - Street 1:111 W ANDERSON LN
Mailing Address - Street 2:SUITE D211
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-1132
Mailing Address - Country:US
Mailing Address - Phone:512-374-9995
Mailing Address - Fax:512-374-0099
Practice Address - Street 1:111 W ANDERSON LN
Practice Address - Street 2:SUITE D211
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78752-1132
Practice Address - Country:US
Practice Address - Phone:512-374-9995
Practice Address - Fax:512-374-0099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies