Provider Demographics
NPI:1316297211
Name:ON-TIME MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:ON-TIME MEDICAL SUPPLY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CANDIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-605-6905
Mailing Address - Street 1:3333 S MARYLAND PKWY
Mailing Address - Street 2:SUITE #2
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89169-3098
Mailing Address - Country:US
Mailing Address - Phone:702-605-6905
Mailing Address - Fax:702-605-6906
Practice Address - Street 1:3333 S MARYLAND PKWY
Practice Address - Street 2:SUITE #2
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89169-3098
Practice Address - Country:US
Practice Address - Phone:702-605-6905
Practice Address - Fax:702-605-6906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No333300000XSuppliersEmergency Response System Companies
No335G00000XSuppliersMedical Foods Supplier