Provider Demographics
NPI:1497149215
Name:NORTH AMERICA DURABLE MEDICAL EQUIPMENT SUPPLY
Entity Type:Organization
Organization Name:NORTH AMERICA DURABLE MEDICAL EQUIPMENT SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REHEMA
Authorized Official - Middle Name:SANDUBE
Authorized Official - Last Name:MWAKAJWANGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-206-0405
Mailing Address - Street 1:3000 WOODLAND PARK DR APT 622
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2651
Mailing Address - Country:US
Mailing Address - Phone:832-206-0405
Mailing Address - Fax:
Practice Address - Street 1:3000 WOODLAND PARK DR APT 622
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2651
Practice Address - Country:US
Practice Address - Phone:832-206-0405
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies