# MOON MEDICAL SUPPLY, INC

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

## Provider details

- **NPI number:** 1508037888
- **Authorized official:** MR. EMMANUEL C OSADEBEY (ASST. PURCH. OFFICER)
- **Authorized official phone:** (214) 905-9105

## Contact information

- **Practice address:** 2730 N STEMMONS FWY BLDG, STE 215, DALLAS, TX 75207-2279
- **Practice address phone:** (214) 905-9105
- **Practice address fax:** (214) 634-3942
- **Mailing address:** 2730 N STEMMONS FWY BLDG STE215, DALLAS, TX 75207-2279
- **Mailing address phone:** (214) 905-9105
- **Mailing address fax:** (214) 634-3942

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332BX2000X | Oxygen Equipment & Supplies (DME) | 0041165 | TX | Yes |

## Other

- **Enumeration date:** 03/14/2008
- **Last updated:** 03/14/2008