Provider Demographics
NPI:1851547681
Name:MDJ MEDICAL SUPPLIES & SERVICES, INC
Entity Type:Organization
Organization Name:MDJ MEDICAL SUPPLIES & SERVICES, INC
Other - Org Name:MDJ HEALTH CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:I
Authorized Official - Last Name:OSINLOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-341-6201
Mailing Address - Street 1:801 K AVE STE 13
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-8575
Mailing Address - Country:US
Mailing Address - Phone:214-341-6201
Mailing Address - Fax:214-540-6621
Practice Address - Street 1:801 K AVE STE 13
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-8575
Practice Address - Country:US
Practice Address - Phone:214-341-6201
Practice Address - Fax:214-540-6621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251E00000X
332B00000X, 3747P1801X
TX0105514332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral NutritionGroup - Single Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6282050001Medicare NSC