Organization Name: | AFAHA M ASANGANSI |
NPI Number: | 1194726455 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | AFAHA MATTHEW ASANGANSI (OWNER OPERATOR) |
Mailing Address: | 7524 S Broadway Ave Ste120 Tyler |
State: | TX US |
Postal Code: | 757035007 |
Phone Number: | 9035093987 |
Fax Number: | 9035099428 |
NPI Enumeration Date: | 08/09/2005 |
NPI Last Update Date: | 08/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | 161161801 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |