Provider Demographics
NPI:1013327253
Name:AMOR SUPPLY
Entity Type:Organization
Organization Name:AMOR SUPPLY
Other - Org Name:N/A
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-528-5879
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VIEW
Mailing Address - State:TX
Mailing Address - Zip Code:77446-0037
Mailing Address - Country:US
Mailing Address - Phone:832-528-5879
Mailing Address - Fax:
Practice Address - Street 1:20707 EMERALD DR.
Practice Address - Street 2:
Practice Address - City:PRAIRIE VIEW
Practice Address - State:TX
Practice Address - Zip Code:77446
Practice Address - Country:US
Practice Address - Phone:832-528-5879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies