| Organization Name: | SOUTH MEDICAL SUPPLY AND EQUIPMENT LLC |
| NPI Number: | 1043339187 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LOVETH ISIDAEHOMEN (OWNER) |
| Mailing Address: | 6523 Duck Creek Dr # B Garland |
| State: | TX US |
| Postal Code: | 750433644 |
| Phone Number: | 9723037602 |
| Fax Number: | |
| NPI Enumeration Date: | 03/28/2007 |
| NPI Last Update Date: | 01/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BC3200X |
| License Number: | 0062174 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Customized Equipment |
| Taxonomy Definition: | |