Provider Demographics
NPI:1417268921
Name:SERENITY HEALTH SUPPLIES INC.
Entity Type:Organization
Organization Name:SERENITY HEALTH SUPPLIES INC.
Other - Org Name:SERENITY HEALTH SUPPLIES
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LAKEESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:POSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LNFA
Authorized Official - Phone:281-973-9239
Mailing Address - Street 1:5338 FM 1960 RD E
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2502
Mailing Address - Country:US
Mailing Address - Phone:281-973-9239
Mailing Address - Fax:
Practice Address - Street 1:5338 FM 1960 RD E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2502
Practice Address - Country:US
Practice Address - Phone:281-973-9239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
TXTXD 15739332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6656050001Medicare NSC