Provider Demographics
NPI:1932373248
Name:AGL MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:AGL MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IJE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOZIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-702-8735
Mailing Address - Street 1:810 S MASON RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-3895
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:810 S MASON RD
Practice Address - Street 2:SUITE 302
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-3895
Practice Address - Country:US
Practice Address - Phone:281-702-8735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies