Provider Demographics
NPI:1992092092
Name:CIDEL MEDICAL SUPPLIES INC.
Entity type:Organization
Organization Name:CIDEL MEDICAL SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:IKE
Authorized Official - Last Name:IFEJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-801-7454
Mailing Address - Street 1:804 W SHORE DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5047
Mailing Address - Country:US
Mailing Address - Phone:972-801-7454
Mailing Address - Fax:
Practice Address - Street 1:804 W SHORE DR
Practice Address - Street 2:SUITE 11
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5047
Practice Address - Country:US
Practice Address - Phone:972-801-7454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-09
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000565332B00000X, 332BN1400X, 332BX2000X
332BC3200X
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
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1000565OtherWHOLESALE DISTRIBUTOR LICENSE