Provider Demographics
NPI:1376839381
Name:TEAM STAT MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:TEAM STAT MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KURT
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:HIPPCHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-906-8489
Mailing Address - Street 1:565 CHESAPEAKE LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-8107
Mailing Address - Country:US
Mailing Address - Phone:214-906-8489
Mailing Address - Fax:817-431-3580
Practice Address - Street 1:565 CHESAPEAKE LN
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-8107
Practice Address - Country:US
Practice Address - Phone:214-906-8489
Practice Address - Fax:817-431-3580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care