Ebony Medical Equipment & Supplies , Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

0056126 Issued in TX

Legal business name

EBONY MEDICAL EQUIPMENT & SUPPLIES , INC

Practice address

427 Troup Hwy
Tyler, TX 75701-5502

Phone

(903) 593-1264

Fax

(903) 533-0156

NPI assigned

Feb 1, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Nicodemus J Udofia

Title

Owner/Ceo

Phone

(903) 593-1264

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ebony Medical Equipment & Supplies , Inc Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1073585451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 TROUP HWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015502",
            "telephone_number": "903-593-1264",
            "fax_number": "903-533-0156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 TROUP HWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015502",
            "telephone_number": "903-593-1264",
            "fax_number": "903-533-0156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBONY MEDICAL EQUIPMENT & SUPPLIES , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "UDOFIA",
        "authorized_official_first_name": "NICODEMUS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "903-593-1264",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0056126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148551802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ebony Medical Equipment & Supplies , Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Durable Medical Equipment & Medical Supplies in Tyler, TX
• Providers in Tyler, TX by specialty
• Durable Medical Equipment & Medical Supplies in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.