Provider Demographics
NPI:1467517078
Name:SAMERICA MEDICAL SUPPLY COMPANY
Entity Type:Organization
Organization Name:SAMERICA MEDICAL SUPPLY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SALIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-507-7803
Mailing Address - Street 1:3225 IH 30
Mailing Address - Street 2:SUITE H1
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-2635
Mailing Address - Country:US
Mailing Address - Phone:972-270-7226
Mailing Address - Fax:972-692-2646
Practice Address - Street 1:3225 IH 30
Practice Address - Street 2:SUITE H1
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2635
Practice Address - Country:US
Practice Address - Phone:972-270-7226
Practice Address - Fax:972-692-2646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5848930001Medicare NSC