Provider Demographics
NPI:1447401823
Name:BONIFACE A. AGU
Entity Type:Organization
Organization Name:BONIFACE A. AGU
Other - Org Name:FIRST CHOICE MEDICAL SUPPLIES EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BONIFACE
Authorized Official - Middle Name:A
Authorized Official - Last Name:AGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-733-2025
Mailing Address - Street 1:8035 E R L THORNTON FWY
Mailing Address - Street 2:SUITE 456
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-7018
Mailing Address - Country:US
Mailing Address - Phone:469-733-2025
Mailing Address - Fax:
Practice Address - Street 1:8035 E R L THORNTON FWY
Practice Address - Street 2:SUITE 456
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-7018
Practice Address - Country:US
Practice Address - Phone:469-733-2025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies