Provider Demographics
NPI:1588856348
Name:MILAN MEDICAL SUPPLIES, LLC
Entity Type:Organization
Organization Name:MILAN MEDICAL SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MACKEAVER
Authorized Official - Middle Name:MECHAEL
Authorized Official - Last Name:RIVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-455-2871
Mailing Address - Street 1:15305 DALLAS PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4637
Mailing Address - Country:US
Mailing Address - Phone:972-455-2871
Mailing Address - Fax:469-252-4581
Practice Address - Street 1:15305 DALLAS PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4637
Practice Address - Country:US
Practice Address - Phone:972-455-2871
Practice Address - Fax:469-252-4581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies