Provider Demographics
NPI:1013603828
Name:EB SUPPLIES DISTRIBUTORS INC
Entity Type:Organization
Organization Name:EB SUPPLIES DISTRIBUTORS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRANCO DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-563-8501
Mailing Address - Street 1:1001 W EULESS BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-5032
Mailing Address - Country:US
Mailing Address - Phone:469-563-8501
Mailing Address - Fax:
Practice Address - Street 1:1001 W EULESS BLVD STE 207
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-5032
Practice Address - Country:US
Practice Address - Phone:469-563-8501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies