Provider Demographics
NPI:1386245009
Name:HAYS MEDICAL SUPPLY LLC JUDSON STURDIVANT SOLE MBR
Entity type:Organization
Organization Name:HAYS MEDICAL SUPPLY LLC JUDSON STURDIVANT SOLE MBR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUDSON
Authorized Official - Middle Name:
Authorized Official - Last Name:STURDIVANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-761-7900
Mailing Address - Street 1:1101 BUNTON CREEK RD UNIT 100B
Mailing Address - Street 2:
Mailing Address - City:KYLE
Mailing Address - State:TX
Mailing Address - Zip Code:78640-2778
Mailing Address - Country:US
Mailing Address - Phone:512-699-3744
Mailing Address - Fax:
Practice Address - Street 1:1101 BUNTON CREEK ROAD
Practice Address - Street 2:STE 100 B
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-2351
Practice Address - Country:US
Practice Address - Phone:512-699-3744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment