# PD MEDICAL SUPPLY INC

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

## Provider details

- **NPI number:** 1306171285
- **Authorized official:** MR. PHILLIP AIGBOGUN ERIMS (ADMINSTRATOR)
- **Authorized official phone:** (469) 878-6315

## Contact information

- **Practice address:** 9550 FOREST LN, SUITE 603, DALLAS, TX 75243
- **Practice address phone:** (469) 878-6315
- **Mailing address:** 9550 FOREST LN, SUITE 603, DALLAS, TX 75243-5905
- **Mailing address phone:** (469) 878-6315

## Taxonomy

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

## Other

- **Enumeration date:** 10/09/2009
- **Last updated:** 10/09/2009