Provider Demographics
NPI:1881961191
Name:CRAWFORD MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:CRAWFORD MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:PREM
Authorized Official - Middle Name:
Authorized Official - Last Name:KALIDINDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-769-8014
Mailing Address - Street 1:2608 N MAIN AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-2919
Mailing Address - Country:US
Mailing Address - Phone:210-225-7400
Mailing Address - Fax:210-569-6266
Practice Address - Street 1:2608 N MAIN AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-2919
Practice Address - Country:US
Practice Address - Phone:210-225-7400
Practice Address - Fax:210-569-6266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-30
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No335G00000XSuppliersMedical Foods Supplier