Provider Demographics
NPI:1487987624
Name:ROCKLAND MEDICAL SUPPLY & EQUIPMENT INC
Entity type:Organization
Organization Name:ROCKLAND MEDICAL SUPPLY & EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUMUYIWA
Authorized Official - Middle Name:E
Authorized Official - Last Name:AKINOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-237-9628
Mailing Address - Street 1:2304 OAK LN
Mailing Address - Street 2:SUITE 114
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-8812
Mailing Address - Country:US
Mailing Address - Phone:972-237-9628
Mailing Address - Fax:972-739-9111
Practice Address - Street 1:2304 OAK LN
Practice Address - Street 2:SUITE 114
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-8812
Practice Address - Country:US
Practice Address - Phone:972-237-9628
Practice Address - Fax:972-739-9111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-04
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000152332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6452990001Medicare NSC