Provider Demographics
NPI:1497092357
Name:C3MJ MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:C3MJ MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVENPORT HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-452-7599
Mailing Address - Street 1:11651 WREN CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77038-3616
Mailing Address - Country:US
Mailing Address - Phone:832-452-7599
Mailing Address - Fax:281-999-1340
Practice Address - Street 1:11651 WREN CROSSING DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77038-3616
Practice Address - Country:US
Practice Address - Phone:832-452-7599
Practice Address - Fax:281-999-1340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-12
Last Update Date:2013-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332BN1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies