Provider Demographics
NPI:1558572487
Name:B I MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:B I MEDICAL SUPPLY LLC
Other - Org Name:B.I.MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BASSEY
Authorized Official - Middle Name:MONDAY
Authorized Official - Last Name:IDIONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-785-1984
Mailing Address - Street 1:9950 WESTPARK DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5188
Mailing Address - Country:US
Mailing Address - Phone:713-785-1984
Mailing Address - Fax:713-787-6317
Practice Address - Street 1:9950 WESTPARK DR STE 260
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-5194
Practice Address - Country:US
Practice Address - Phone:713-785-1984
Practice Address - Fax:713-787-6317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0086921332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6001260001Medicare NSC
TX5726590001Medicare NSC