Provider Demographics
NPI:1992721351
Name:JOPPA TRADINGS AND MEDICAL SUPPLIES INC.
Entity type:Organization
Organization Name:JOPPA TRADINGS AND MEDICAL SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATHAI
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAMUEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-285-0600
Mailing Address - Street 1:PO BOX 851305
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75185-1305
Mailing Address - Country:US
Mailing Address - Phone:972-285-0600
Mailing Address - Fax:972-285-0142
Practice Address - Street 1:740 MILITARY PKWY
Practice Address - Street 2:SUITE E
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-4166
Practice Address - Country:US
Practice Address - Phone:972-285-0600
Practice Address - Fax:972-285-0142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0089528332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
5724690001Medicare NSC