Provider Demographics
NPI:1639288806
Name:ABC MEDICAL SUPPLIES, INC
Entity Type:Organization
Organization Name:ABC MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:COWART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-421-2412
Mailing Address - Street 1:7806 HIAWATHA ST
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-8819
Mailing Address - Country:US
Mailing Address - Phone:281-421-8742
Mailing Address - Fax:281-421-8741
Practice Address - Street 1:5624 GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-9626
Practice Address - Country:US
Practice Address - Phone:281-421-8742
Practice Address - Fax:281-421-8741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0032887332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0585420001Medicare NSC