Provider Demographics
NPI:1437398708
Name:AMERICAN CARE MEDICAL SUPPLY
Entity Type:Organization
Organization Name:AMERICAN CARE MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OLALEKAN
Authorized Official - Middle Name:ADEMOLA
Authorized Official - Last Name:AGBOLUAJE
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:281-221-5260
Mailing Address - Street 1:6610 HARWIN DR STE 216
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2227
Mailing Address - Country:US
Mailing Address - Phone:281-385-9800
Mailing Address - Fax:
Practice Address - Street 1:6610 HARWIN DR STE 216
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2227
Practice Address - Country:US
Practice Address - Phone:281-385-9800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0108075332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment