Provider Demographics
NPI:1619510716
Name:MEDICAL SUPPLIES OF USA LLC
Entity Type:Organization
Organization Name:MEDICAL SUPPLIES OF USA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAHBAA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAIDAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:915-496-3083
Mailing Address - Street 1:2200 N LEE TREVINO DR STE A6
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-3409
Mailing Address - Country:US
Mailing Address - Phone:915-213-3082
Mailing Address - Fax:866-200-2812
Practice Address - Street 1:2200 N LEE TREVINO DR STE A6
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-3409
Practice Address - Country:US
Practice Address - Phone:915-213-3082
Practice Address - Fax:866-200-2812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies