Organization
NICKES MEDICAL SUPPLY, LLC
Active
Parent organization
NICKES MEDICAL SUPPLY, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NICKES MEDICAL SUPPLY, LLC
Authorized official
NGOZI AUSTIN-ELEJE (MANAGER)
(915) 633-3724
Entity
Organization
Contact information
Practice address
215 EAST BROADWAY, VAN HORN, TX 79855
(432) 283-1000
(915) 533-0078
Mailing address
2820 N STANTON ST, EL PASO, TX 79902-2509
(915) 633-3724
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
0094093
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
187854801
—
TX
Enumeration date
07/29/2016
Last updated
09/02/2016
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