Provider Demographics
NPI:1942389697
Name:ACOSTA MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:ACOSTA MEDICAL SUPPLY INC
Other - Org Name:AFFORDABLE MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OKPAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-472-7357
Mailing Address - Street 1:PO BOX 583
Mailing Address - Street 2:
Mailing Address - City:ALIEF
Mailing Address - State:TX
Mailing Address - Zip Code:77411-0583
Mailing Address - Country:US
Mailing Address - Phone:713-472-7357
Mailing Address - Fax:713-778-8194
Practice Address - Street 1:10333 HARWIN DR # 545
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-1545
Practice Address - Country:US
Practice Address - Phone:713-472-7357
Practice Address - Fax:713-778-9184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies