Provider Demographics
NPI:1356408504
Name:IMMEDIATE MEDICAL EQUIPMENT PROVIDERS
Entity type:Organization
Organization Name:IMMEDIATE MEDICAL EQUIPMENT PROVIDERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:GONZALES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-450-7600
Mailing Address - Street 1:2616 SOUTH LOOP W
Mailing Address - Street 2:SUITE 594
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2662
Mailing Address - Country:US
Mailing Address - Phone:866-950-4637
Mailing Address - Fax:713-592-0800
Practice Address - Street 1:2616 SOUTH LOOP W
Practice Address - Street 2:SUITE 594
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2662
Practice Address - Country:US
Practice Address - Phone:866-950-4637
Practice Address - Fax:713-592-0800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies