Provider Demographics
NPI:1174166615
Name:MASVIDA HEALTH CARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:MASVIDA HEALTH CARE SOLUTIONS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SVP OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITELEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-704-3103
Mailing Address - Street 1:133 NURSERY LN
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76114-4334
Mailing Address - Country:US
Mailing Address - Phone:817-697-7119
Mailing Address - Fax:817-447-8855
Practice Address - Street 1:13304 HWY 110 S STE 300
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75707-6380
Practice Address - Country:US
Practice Address - Phone:682-249-8926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MASVIDA HEALTH CARE SOLUTIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-28
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies