Provider Demographics
NPI:1336445790
Name:C I M, LLC
Entity type:Organization
Organization Name:C I M, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:TAHER
Authorized Official - Last Name:FATAKDAWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-217-9838
Mailing Address - Street 1:11514 SWIFTWATER BRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-7049
Mailing Address - Country:US
Mailing Address - Phone:832-886-0202
Mailing Address - Fax:832-604-4040
Practice Address - Street 1:11514 SWIFTWATER BRIDGE LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-7049
Practice Address - Country:US
Practice Address - Phone:832-886-0202
Practice Address - Fax:832-604-4040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-02
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies