Provider Demographics
NPI:1881839645
Name:ASIKO MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:ASIKO MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ZIEM
Authorized Official - Last Name:OGWU
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:512-218-0509
Mailing Address - Street 1:309 W-MAIN ST
Mailing Address - Street 2:SUITE 117
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664
Mailing Address - Country:US
Mailing Address - Phone:512-218-0509
Mailing Address - Fax:512-218-1904
Practice Address - Street 1:309 W-MAIN ST
Practice Address - Street 2:SUITE 117
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664
Practice Address - Country:US
Practice Address - Phone:512-218-0509
Practice Address - Fax:512-218-1904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies