Organization
AMERICAN GENERAL MERCHANTS INC.
Active
Other names
AMERICAN GENERAL MEDICAL SUPPLY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IDRIS ELIJA SALIA (PRESIDENT)
(214) 415-5554
Entity
Organization
Contact information
Practice address
3213 INTERSTATE 30 STE 108, MESQUITE, TX 75150-2603
(972) 270-0500
(972) 674-2944
Mailing address
3213 INTERSTATE 30 STE 108, MESQUITE, TX 75150-2603
(972) 270-0500
(972) 674-2944
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BD1200X
Dialysis Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1002022
TEXAS DEVICE DISTRIBUTOR LICENSE
TX
05
—
3925968
—
TX
Enumeration date
10/23/2017
Last updated
04/22/2020
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