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Organization
SOUTHLAKE MEDICAL SUPPLIES, INC.
Active
Organization
SOUTHLAKE MEDICAL SUPPLIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY COZZIE (PRESIDENT)
(817) 319-8090
Entity
Organization
Contact information
Practice address
2140 E. SOUTHLAKE BLVD., #L-675, SOUTHLAKE, TX 76092-6516
(817) 319-8090
Mailing address
2140 E. SOUTHLAKE BLVD., #L-675, SOUTHLAKE, TX 76092-6516
(817) 319-8090
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0054467
TX
Other
Enumeration date
05/26/2006
Last updated
09/22/2022
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