Provider Demographics
NPI:1952665093
Name:TOSCANA DISTRIBUTORS
Entity Type:Organization
Organization Name:TOSCANA DISTRIBUTORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EIHAB
Authorized Official - Middle Name:JAMAL
Authorized Official - Last Name:ABDELRAZZAQ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-406-8881
Mailing Address - Street 1:2700 FOREST LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7308
Mailing Address - Country:US
Mailing Address - Phone:972-406-8881
Mailing Address - Fax:972-406-8883
Practice Address - Street 1:2700 FOREST LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7308
Practice Address - Country:US
Practice Address - Phone:972-406-8881
Practice Address - Fax:972-406-8883
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TUSCAN FLOORS DISTRIBUTOR, CORP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care