Provider Demographics
NPI:1669074571
Name:HAYS MEDICAL SUPPLY LLC JUDSON STURDIVANT SOLE MBR
Entity type:Organization
Organization Name:HAYS MEDICAL SUPPLY LLC JUDSON STURDIVANT SOLE MBR
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUDSON
Authorized Official - Middle Name:
Authorized Official - Last Name:STURDIVANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-697-9896
Mailing Address - Street 1:5508 PARKCREST DR STE 310
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4915
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5508 PARKCREST DR STE 310
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4915
Practice Address - Country:US
Practice Address - Phone:512-697-9896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAYS MEDICAL SUPPLY LLC JUDSON STURDIVANT SOLE MBR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-15
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies