Provider Demographics
NPI:1700604824
Name:SI MEDICAL EQUIPMENT SERVICES LLC
Entity type:Organization
Organization Name:SI MEDICAL EQUIPMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHAZEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:FAROOQI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-900-3786
Mailing Address - Street 1:320 VALENTINO WAY
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-0025
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:320 VALENTINO WAY
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-0025
Practice Address - Country:US
Practice Address - Phone:972-900-3786
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-27
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies