Provider Demographics
NPI:1891874640
Name:NICHE MEDICAL SALES INC
Entity type:Organization
Organization Name:NICHE MEDICAL SALES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KENLYN
Authorized Official - Middle Name:DEROCHE
Authorized Official - Last Name:OJONTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-463-4113
Mailing Address - Street 1:7066 LAKEVIEW HAVEN DR
Mailing Address - Street 2:SUITE 125B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2568
Mailing Address - Country:US
Mailing Address - Phone:281-463-4113
Mailing Address - Fax:281-463-4033
Practice Address - Street 1:7066 LAKEVIEW HAVEN DR
Practice Address - Street 2:SUITE 125B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2568
Practice Address - Country:US
Practice Address - Phone:281-463-4113
Practice Address - Fax:281-463-4033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5631720001Medicare NSC