Provider Demographics
NPI:1104984095
Name:MANNA MEDICAL EQUIPMENT
Entity type:Organization
Organization Name:MANNA MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JEE
Authorized Official - Middle Name:
Authorized Official - Last Name:DELLOTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-541-6600
Mailing Address - Street 1:2685 N CORIA ST
Mailing Address - Street 2:STE C-1
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8810
Mailing Address - Country:US
Mailing Address - Phone:956-541-6600
Mailing Address - Fax:956-541-9676
Practice Address - Street 1:2685 N CORIA ST
Practice Address - Street 2:STE C-1
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-8810
Practice Address - Country:US
Practice Address - Phone:956-541-6600
Practice Address - Fax:956-541-9676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0092046332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies