Organization
EBONY MEDICAL EQUIPMENT & SUPPLIES , INC
Active
Other names
Ebony Medical Equipment & Supplies , Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICODEMUS J UDOFIA (OWNER/CEO)
(903) 593-1264
Entity
Organization
Contact information
Practice address
427 TROUP HWY, TYLER, TX 75701-5502
(903) 593-1264
(903) 533-0156
Mailing address
427 TROUP HWY, TYLER, TX 75701-5502
(903) 593-1264
(903) 533-0156
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0056126
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148551802
—
TX
Enumeration date
02/01/2006
Last updated
07/15/2008
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