# HEAVENLY SENT INCONTINENCE SUPPLY

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

## Provider details

- **NPI number:** 1902077076
- **Authorized official:** MARISELA D. SALAS (OWNER)
- **Authorized official phone:** (361) 442-0720

## Contact information

- **Practice address:** 5959 S STAPLES ST, SUITE 104, CORPUS CHRISTI, TX 78413-3846
- **Practice address phone:** (361) 442-0720
- **Mailing address:** 5959 S STAPLES ST, SUITE 104, CORPUS CHRISTI, TX 78413-3846
- **Mailing address phone:** (361) 442-0720

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0101990 | TX | Yes |

## Other

- **Enumeration date:** 03/17/2008
- **Last updated:** 03/17/2008