# IGIETSU MEDICAL GENERAL MERCHANDIZE/SUPPLIES

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

## Provider details

- **NPI number:** 1396982401
- **Authorized official:** MR. AHMADU IGIETSU (OWNER)
- **Authorized official phone:** (817) 300-3640

## Contact information

- **Practice address:** 1411 E ABRAM ST STE D, ARLINGTON, TX 76010-7228
- **Practice address phone:** (817) 300-3640
- **Practice address fax:** (817) 277-4406
- **Mailing address:** 1411 EAST ABRAM ST.STE. D, ARLINGTON, TX 76010
- **Mailing address phone:** (817) 300-3640
- **Mailing address fax:** (817) 277-4406

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0093044 | TX | Yes |

## Other

- **Enumeration date:** 01/12/2009
- **Last updated:** 09/23/2009