Provider Demographics
NPI:1467555706
Name:ASA MEDICAL EQUIPMENT & SUPPLIES
Entity Type:Organization
Organization Name:ASA MEDICAL EQUIPMENT & SUPPLIES
Other - Org Name:METRO MEDICAL DISTRIBUTORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ESSIEN
Authorized Official - Middle Name:COBY
Authorized Official - Last Name:COBHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-709-4433
Mailing Address - Street 1:PO BOX 382637
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75138-2637
Mailing Address - Country:US
Mailing Address - Phone:972-709-4433
Mailing Address - Fax:972-709-4434
Practice Address - Street 1:700 S COCKRELL HILL RD
Practice Address - Street 2:SUITE 184
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-2600
Practice Address - Country:US
Practice Address - Phone:972-709-4433
Practice Address - Fax:972-709-4434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0073631332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171355401Medicaid
TX171355402Medicaid
TX5233050001Medicare NSC