Provider Demographics
NPI:1811616196
Name:THE BILLIONAIRE WOMEN'S CLUB CHARITY
Entity type:Organization
Organization Name:THE BILLIONAIRE WOMEN'S CLUB CHARITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:QUANTAE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DEVICE DISTRIBUTOR
Authorized Official - Phone:214-727-5791
Mailing Address - Street 1:1910 PACIFIC AVE # 12015
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-4529
Mailing Address - Country:US
Mailing Address - Phone:972-803-5940
Mailing Address - Fax:
Practice Address - Street 1:1910 PACIFIC AVE # 12015
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-4529
Practice Address - Country:US
Practice Address - Phone:972-803-5940
Practice Address - Fax:214-484-1972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies