# IGIETSU MEDICAL &GENERAL MERCHANDIZE SUPPLIES

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

## Provider details

- **NPI number:** 1578733440
- **Authorized official:** AHMADU EMMANESI IGIETSU (CEO)
- **Authorized official phone:** (817) 300-3640

## Contact information

- **Practice address:** 1411A E ABRAM ST STE D, ARLINGTON, TX 76010-7212
- **Practice address phone:** (817) 300-3640
- **Practice address fax:** (817) 277-4406
- **Mailing address:** PO BOX 182158, ARLINGTON, TX 76096-2158
- **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 | — | NULL | Yes |

## Other

- **Enumeration date:** 03/07/2008
- **Last updated:** 03/07/2008