Provider Demographics
NPI:1336187319
Name:PARIS MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:PARIS MEDICAL SUPPLY, INC.
Other - Org Name:ANTLERS MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:G
Authorized Official - Last Name:NIXON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-785-6615
Mailing Address - Street 1:215 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:ANTLERS
Mailing Address - State:OK
Mailing Address - Zip Code:74523-2237
Mailing Address - Country:US
Mailing Address - Phone:580-298-3210
Mailing Address - Fax:580-298-9925
Practice Address - Street 1:215 N HIGH ST
Practice Address - Street 2:
Practice Address - City:ANTLERS
Practice Address - State:OK
Practice Address - Zip Code:74523-2237
Practice Address - Country:US
Practice Address - Phone:580-298-3210
Practice Address - Fax:580-298-9925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK59S1106332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0595450003Medicare NSC