Provider Demographics
NPI:1346418662
Name:GALAXY MEDICAL SUPPLY INC.
Entity Type:Organization
Organization Name:GALAXY MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HABIBA
Authorized Official - Middle Name:NGOZI
Authorized Official - Last Name:CISSE IKPEOHA
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:602-841-0700
Mailing Address - Street 1:6201 N 35TH AVE STE B5
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85017-1413
Mailing Address - Country:US
Mailing Address - Phone:602-841-2009
Mailing Address - Fax:
Practice Address - Street 1:6201 N 35TH AVE STE B5
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85017-1413
Practice Address - Country:US
Practice Address - Phone:602-841-2009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies