# OPEN-HEAVEN MEDICAL SUPPLY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093998916
- **Authorized official:** PAUL OLALEKAN AMOSUN (OFFICE MANAGER)
- **Authorized official phone:** (972) 459-5555

## Contact information

- **Practice address:** 860 HEBRON PKWY, SUITE 502, LEWISVILLE, TX 75057-5003
- **Practice address phone:** (972) 459-5555
- **Mailing address:** 860 HEBRON PKWY, SUITE 502, LEWISVILLE, TX 75057-5003
- **Mailing address phone:** (972) 459-5555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | N/A | NULL | — |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 6043840001 | TX | Yes |

## Other

- **Enumeration date:** 12/13/2007
- **Last updated:** 06/23/2008