Organization
HEALTH SHACK MEDICAL EQUIPMENT & SUPPLY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIE NATHANIEL LONG III (CEO/PRESIDENT)
(281) 261-9616
Entity
Organization
Contact information
Practice address
610 MURPHY RD, SUITE 107, STAFFORD, TX 77477-5926
(281) 261-9616
(281) 261-2013
Mailing address
610 MURPHY RD, SUITE 107, STAFFORD, TX 77477-5926
(281) 261-9616
(281) 261-2013
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1000071
TX
Other
Enumeration date
04/08/2010
Last updated
04/08/2010
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