Provider Demographics
NPI:1972882959
Name:RSI MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:RSI MEDICAL SUPPLY LLC
Other - Org Name:UNITED MEDICAL SUPPLY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOE
Authorized Official - Middle Name:W
Authorized Official - Last Name:LUCERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-447-7747
Mailing Address - Street 1:2636 S LOOP W
Mailing Address - Street 2:SUITE 675
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-5638
Mailing Address - Country:US
Mailing Address - Phone:713-440-7149
Mailing Address - Fax:
Practice Address - Street 1:2636 S LOOP W
Practice Address - Street 2:SUITE 675
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-5638
Practice Address - Country:US
Practice Address - Phone:713-440-7149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-09
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ704498Medicaid
TX295033902Medicaid
TX295033901Medicaid
TX295033901Medicaid