Provider Demographics
NPI:1356582068
Name:NATIONAL DURABLE MEDICAL SUPPLY
Entity type:Organization
Organization Name:NATIONAL DURABLE MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNEDY
Authorized Official - Middle Name:
Authorized Official - Last Name:OBANOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-216-2555
Mailing Address - Street 1:301 S 9TH ST STE 107
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-3448
Mailing Address - Country:US
Mailing Address - Phone:832-595-0004
Mailing Address - Fax:877-915-1555
Practice Address - Street 1:301 S 9TH ST STE 107
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-3448
Practice Address - Country:US
Practice Address - Phone:832-595-0004
Practice Address - Fax:877-915-1555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-10
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6232720001Medicare NSC