Provider Demographics
NPI:1942063524
Name:MASVIDA HEALTH CARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:MASVIDA HEALTH CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITELEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-704-3103
Mailing Address - Street 1:133 NURSERY LN
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76114-4334
Mailing Address - Country:US
Mailing Address - Phone:817-704-3103
Mailing Address - Fax:
Practice Address - Street 1:4710 EISENHOWER BLVD STE E1
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33634-6336
Practice Address - Country:US
Practice Address - Phone:817-704-3103
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASVIDA HEALTH CARE SOLUTIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies