Provider Demographics
NPI:1679577902
Name:MERC MEDICAL SUPPLY CO INC
Entity type:Organization
Organization Name:MERC MEDICAL SUPPLY CO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSEFINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LISING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-270-4936
Mailing Address - Street 1:10518 KIPP WAY STE D
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77099-2400
Mailing Address - Country:US
Mailing Address - Phone:713-270-4936
Mailing Address - Fax:713-270-0343
Practice Address - Street 1:10518 KIPP WAY DR
Practice Address - Street 2:UNIT D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77099-2400
Practice Address - Country:US
Practice Address - Phone:713-270-4936
Practice Address - Fax:713-270-0343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1147560001Medicare NSC