Provider Demographics
NPI:1760684906
Name:MEMORIAL MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:MEMORIAL MEDICAL SUPPLY, INC.
Other - Org Name:MEMORIAL MEDICAL SUPPLY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUNNY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-556-6565
Mailing Address - Street 1:1009 DAIRY ASHFORD ST # B
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-4602
Mailing Address - Country:US
Mailing Address - Phone:281-556-6565
Mailing Address - Fax:281-556-6566
Practice Address - Street 1:1009 DAIRY ASHFORD ST # B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-4602
Practice Address - Country:US
Practice Address - Phone:281-556-6565
Practice Address - Fax:281-556-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies