Provider Demographics
NPI:1730775057
Name:APACHE MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:APACHE MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:
Authorized Official - Last Name:HEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-542-3020
Mailing Address - Street 1:7324 SOUTHWEST FWY STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2043
Mailing Address - Country:US
Mailing Address - Phone:713-208-0123
Mailing Address - Fax:
Practice Address - Street 1:11200 BROADWAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2043
Practice Address - Country:US
Practice Address - Phone:866-542-3020
Practice Address - Fax:346-816-7690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-21
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies