Provider Demographics
NPI:1073340279
Name:AVB MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:AVB MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AVIS
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-472-9200
Mailing Address - Street 1:2300 VALLEY VIEW LN STE 506
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-1838
Mailing Address - Country:US
Mailing Address - Phone:469-472-9200
Mailing Address - Fax:
Practice Address - Street 1:2300 VALLEY VIEW LN STE 506
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-1838
Practice Address - Country:US
Practice Address - Phone:469-472-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies