Provider Demographics
NPI:1497982854
Name:ABC HOME MEDICAL SUPPLY, INC
Entity Type:Organization
Organization Name:ABC HOME MEDICAL SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-279-9090
Mailing Address - Street 1:12630 E. NORTHWEST HWY.
Mailing Address - Street 2:SUITE 303
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-8024
Mailing Address - Country:US
Mailing Address - Phone:972-279-9090
Mailing Address - Fax:972-270-7282
Practice Address - Street 1:2375 EAST CAMELBACK RD.
Practice Address - Street 2:5TH FLOOR
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-3424
Practice Address - Country:US
Practice Address - Phone:866-897-8588
Practice Address - Fax:972-270-7282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies