Organization
IGIETSU MEDICAL GENERAL MERCHANDIZE/SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AHMADU IGIETSU (OWNER)
(817) 300-3640
Entity
Organization
Contact information
Practice address
1411 E ABRAM ST STE D, ARLINGTON, TX 76010-7228
(817) 300-3640
(817) 277-4406
Mailing address
1411 EAST ABRAM ST.STE. D, ARLINGTON, TX 76010
(817) 300-3640
(817) 277-4406
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0093044
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198191201
—
TX
Enumeration date
01/12/2009
Last updated
09/23/2009
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