NPIMap

Organization Active NPI

Igietsu Medical General Merchandize/Supplies

  • Durable Medical Equipment & Medical Supplies
  • Arlington, TX
National Provider Identifier
1396982401
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0093044 Issued in TX
Legal business name
IGIETSU MEDICAL GENERAL MERCHANDIZE/SUPPLIES
Practice address
1411 E Abram St Ste D
Arlington, TX 76010-7228
Phone
(817) 300-3640
Fax
(817) 277-4406
NPI assigned
Jan 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Authorized official

Name
Mr. Ahmadu IgietsuNPI 1356492805
Title
Owner
Phone
(817) 300-3640

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0093044 TX Primary

Addresses

Primary practice location

1411 E Abram St Ste D
Arlington, TX 76010-7228

Mailing address

1411 East Abram St.Ste. D
Arlington, TX 76010
Phone (817) 300-3640

Other identifiers 1

IdentifierTypeStateIssuer
198191201MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Igietsu Medical General Merchandize Supplies2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1396982401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 EAST ABRAM ST.STE. D",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76010",
            "telephone_number": "817-300-3640",
            "fax_number": "817-277-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E ABRAM ST STE D",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760107228",
            "telephone_number": "817-300-3640",
            "fax_number": "817-277-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGIETSU MEDICAL GENERAL MERCHANDIZE/SUPPLIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-12",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "IGIETSU",
        "authorized_official_first_name": "AHMADU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-300-3640",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "0093044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "198191201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; 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.