Provider Demographics
NPI:1962830364
Name:HEALTHCARE MEDSUPPLY LLC
Entity type:Organization
Organization Name:HEALTHCARE MEDSUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-337-1995
Mailing Address - Street 1:803 GALLAGHER DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-1750
Mailing Address - Country:US
Mailing Address - Phone:903-487-2009
Mailing Address - Fax:855-405-4409
Practice Address - Street 1:803 GALLAGHER DR
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-1750
Practice Address - Country:US
Practice Address - Phone:903-487-2009
Practice Address - Fax:855-405-4409
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHCARE MEDSUPPLY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-10-22
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32052041038332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies