Provider Demographics
NPI:1548040579
Name:TRISTAR EQUIPMENT & MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:TRISTAR EQUIPMENT & MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FUNSHO
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:FADIPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-344-8975
Mailing Address - Street 1:12705 S KIRKWOOD RD STE 203
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3813
Mailing Address - Country:US
Mailing Address - Phone:281-302-5335
Mailing Address - Fax:281-302-5390
Practice Address - Street 1:12705 S KIRKWOOD RD STE 203
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3813
Practice Address - Country:US
Practice Address - Phone:281-302-5335
Practice Address - Fax:281-302-5390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies