Provider Demographics
NPI:1740501261
Name:FRIENDLY DME & SUPPLIES LLC
Entity type:Organization
Organization Name:FRIENDLY DME & SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWERNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:IMELDA
Authorized Official - Middle Name:F
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-256-0826
Mailing Address - Street 1:3512 BUDDY OWENS AVE
Mailing Address - Street 2:STE 4
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-5465
Mailing Address - Country:US
Mailing Address - Phone:956-683-9039
Mailing Address - Fax:956-683-9034
Practice Address - Street 1:3512 BUDDY OWENS AVE
Practice Address - Street 2:STE 4
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-5465
Practice Address - Country:US
Practice Address - Phone:956-683-9039
Practice Address - Fax:956-683-9034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-18
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC6495330001Medicare NSC