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Organization

IKE GINIS

Active
Other names
PHELIYK MEDICAL SUPPLY
Organization subpart
No

Provider details

NPI number
Authorized official
IKE GINIS (CEO)
(972) 699-7600
Entity
Organization

Contact information

Practice address
777 S CENTRAL EXPY, SUITE 1B, RICHARDSON, TX 75080-7411
(972) 699-7600
Mailing address
777 S CENTRAL EXPY, SUITE 1B, RICHARDSON, TX 75080-7411
(972) 699-7600

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0062948
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
154401701
TX
05
154401702
TX
Enumeration date
06/23/2006
Last updated
06/25/2008
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