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Organization
MEDICAL DEPOT, INC
Active
Organization
MEDICAL DEPOT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEAH LORANE KENNEDY (OWNER)
(713) 440-6017
Entity
Organization
Contact information
Practice address
7311 ARDMORE ST, BLDG A & B, HOUSTON, TX 77054-4205
(713) 440-6017
(713) 747-9076
Mailing address
7311 ARDMORE ST, BLDG A & B, HOUSTON, TX 77054-4205
(713) 440-6017
(713) 747-9076
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
0104583
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
0104583
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0104583
TX
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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