Organization
DIMEDICAL EQUIPMENT& SUPPLY ,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTHONY ETIM UMANA (ADMINISTRATOR)
(903) 595-1303
Entity
Organization
Contact information
Practice address
1429 S FLEISHEL AVE, TYLER, TX 75701-3355
(903) 595-1303
(903) 595-1326
Mailing address
1429 S FLEISHEL AVE, TYLER, TX 75701-3355
(903) 595-1303
(903) 595-1326
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
163387701
TX
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163387701
—
TX
Enumeration date
10/28/2008
Last updated
10/28/2008
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