Provider Demographics
NPI:1194349589
Name:CJAND MEDICAL EQUIPMENT AND SUPPLIES
Entity type:Organization
Organization Name:CJAND MEDICAL EQUIPMENT AND SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DELPHINA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MITIMA-SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:409-350-8167
Mailing Address - Street 1:12315 BELLAIRE BLVD STE 800
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77072-2557
Mailing Address - Country:US
Mailing Address - Phone:409-350-8167
Mailing Address - Fax:281-741-9008
Practice Address - Street 1:12315 BELLAIRE BLVD STE 800
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77072-2557
Practice Address - Country:US
Practice Address - Phone:409-350-8167
Practice Address - Fax:281-741-9008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies