Provider Demographics
NPI:1174737019
Name:ZENITH MEDICAL SUPPLIES AND EQUIPMENT INC.
Entity type:Organization
Organization Name:ZENITH MEDICAL SUPPLIES AND EQUIPMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHUKWUEMEKA
Authorized Official - Middle Name:E
Authorized Official - Last Name:IFENWANTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-664-0555
Mailing Address - Street 1:13999 GOLDMARK DR
Mailing Address - Street 2:SUITE 304
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-4234
Mailing Address - Country:US
Mailing Address - Phone:972-664-0555
Mailing Address - Fax:972-664-0556
Practice Address - Street 1:13999 GOLDMARK DR
Practice Address - Street 2:SUITE 304
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-4267
Practice Address - Country:US
Practice Address - Phone:972-664-0555
Practice Address - Fax:972-664-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-10
Last Update Date:2008-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95934332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188798602Medicaid
TX188798601Medicaid
TX188798601Medicaid