Provider Demographics
NPI:1912930496
Name:SAFLOY MEDICAL SUPPLY CORPORATION
Entity Type:Organization
Organization Name:SAFLOY MEDICAL SUPPLY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:MGBEDEM
Authorized Official - Last Name:OKOLIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-652-4493
Mailing Address - Street 1:2308 CREST PARK DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-2801
Mailing Address - Country:US
Mailing Address - Phone:817-652-4493
Mailing Address - Fax:817-652-4431
Practice Address - Street 1:2308 CREST PARK DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-2801
Practice Address - Country:US
Practice Address - Phone:817-652-4493
Practice Address - Fax:817-652-4431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0071383332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0071383OtherSTATE LICENCE #
TX17075150Medicaid
TX17075150Medicaid