Organization
KINGSWAY MEDICAL SYSTEMS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP ODOEMENA (ADMINISTRATOR)
(972) 228-8111
Entity
Organization
Contact information
Practice address
331 MELROSE DR, SUITE 102, RICHARDSON, TX 75080-4405
(972) 228-8111
(972) 228-8332
Mailing address
331 MELROSE DR, SUITE 102, RICHARDSON, TX 75080-4405
(972) 228-8111
(972) 228-8332
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5415750001
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5415750001
DME SUPPLIER
TX
Enumeration date
12/18/2006
Last updated
10/24/2007
Update your record
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