Provider Demographics
NPI:1700639671
Name:BAYTOWN MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:BAYTOWN MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROSIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-452-4021
Mailing Address - Street 1:2005 WARD RD
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-5504
Mailing Address - Country:US
Mailing Address - Phone:832-596-8750
Mailing Address - Fax:
Practice Address - Street 1:2005 WARD RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-5504
Practice Address - Country:US
Practice Address - Phone:832-596-8750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies