Provider Demographics
NPI:1023177466
Name:MED SHOP PLUS, INC.
Entity type:Organization
Organization Name:MED SHOP PLUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHIAMPI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-469-4032
Mailing Address - Street 1:11585 FM 1960 RD W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3607
Mailing Address - Country:US
Mailing Address - Phone:281-469-4032
Mailing Address - Fax:281-477-6801
Practice Address - Street 1:11585 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3607
Practice Address - Country:US
Practice Address - Phone:281-469-4032
Practice Address - Fax:281-477-6801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0040223332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX010205501Medicaid
TX0679890001Medicare NSC