# EBONY MEDICAL EQUIPMENT & SUPPLIES , INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ebony Medical Equipment & Supplies , Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073585451
- **Authorized official:** MR. NICODEMUS J UDOFIA (OWNER/CEO)
- **Authorized official phone:** (903) 593-1264

## Contact information

- **Practice address:** 427 TROUP HWY, TYLER, TX 75701-5502
- **Practice address phone:** (903) 593-1264
- **Practice address fax:** (903) 533-0156
- **Mailing address:** 427 TROUP HWY, TYLER, TX 75701-5502
- **Mailing address phone:** (903) 593-1264
- **Mailing address fax:** (903) 533-0156

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0056126 | TX | Yes |

## Other

- **Enumeration date:** 02/01/2006
- **Last updated:** 07/15/2008