# BONAGE MEDICAL SUPPLY, LLC

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

## Provider details

- **NPI number:** 1942504709
- **Authorized official:** MR. GOODNEWS BONAGE (PRESIDENT)
- **Authorized official phone:** (713) 278-2000

## Contact information

- **Practice address:** 9101 LIPAN RD, 105, HOUSTON, TX 77063-5568
- **Practice address phone:** (713) 278-2000
- **Practice address fax:** (713) 278-2002
- **Mailing address:** 9101 LIPAN RD, 105, HOUSTON, TX 77063-5568
- **Mailing address phone:** (713) 278-2000
- **Mailing address fax:** (713) 278-2002

## Taxonomy

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

## Other

- **Enumeration date:** 01/07/2011
- **Last updated:** 08/01/2015