Provider Demographics
NPI:1477091817
Name:NEW WAY MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:NEW WAY MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:CALEB
Authorized Official - Last Name:CHEATHEAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-968-8642
Mailing Address - Street 1:17305 IH 35 NORTH
Mailing Address - Street 2:SUITE 128
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154
Mailing Address - Country:US
Mailing Address - Phone:210-612-4343
Mailing Address - Fax:
Practice Address - Street 1:17305 IH 35 NORTH
Practice Address - Street 2:SUITE 128
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154
Practice Address - Country:US
Practice Address - Phone:210-612-4343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-06
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001373332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies