Provider Demographics
NPI:1396927687
Name:CSG MEDICAL SUPPLY & UNIFORM LLC
Entity type:Organization
Organization Name:CSG MEDICAL SUPPLY & UNIFORM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AZAGIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-534-8900
Mailing Address - Street 1:3717 HIGHWAY 3
Mailing Address - Street 2:SUITE E
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-8016
Mailing Address - Country:US
Mailing Address - Phone:281-534-8900
Mailing Address - Fax:281-534-8904
Practice Address - Street 1:3717 HIGHWAY 3
Practice Address - Street 2:SUITE E
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-8016
Practice Address - Country:US
Practice Address - Phone:281-534-8900
Practice Address - Fax:281-534-8904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6063700001Medicare NSC