Provider Demographics
NPI:1396719621
Name:HERMANN MEDICAL SUPPLIES, INC
Entity type:Organization
Organization Name:HERMANN MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-392-1114
Mailing Address - Street 1:439 MASON PARK BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6242
Mailing Address - Country:US
Mailing Address - Phone:281-392-1114
Mailing Address - Fax:281-392-1146
Practice Address - Street 1:439 MASON PARK BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6242
Practice Address - Country:US
Practice Address - Phone:281-392-1114
Practice Address - Fax:281-392-1146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX 0012914332B00000X
TX0080003332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176234601Medicaid
TX176234602Medicaid
TX176234601Medicaid