Provider Demographics
NPI:1619746906
Name:AWAN MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:AWAN MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AYIGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-200-3213
Mailing Address - Street 1:9550 FOREST LN STE 323
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-6067
Mailing Address - Country:US
Mailing Address - Phone:214-200-3213
Mailing Address - Fax:214-200-3245
Practice Address - Street 1:9550 FOREST LN STE 323
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6067
Practice Address - Country:US
Practice Address - Phone:214-200-3213
Practice Address - Fax:214-200-3245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-27
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies