1205830197 NPI number — AMERICAN MEDICAL SUPPLIES INC

Table of content: (NPI 1205830197)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205830197 NPI number — AMERICAN MEDICAL SUPPLIES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN MEDICAL SUPPLIES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
AMERICAN MEDICAL SUPPLIES, INC.
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205830197
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/07/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
751 PARK OF COMMERCE DR
Provider Second Line Business Mailing Address:
SUITE 136
Provider Business Mailing Address City Name:
BOCA RATON
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33487-3626
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-575-2345
Provider Business Mailing Address Fax Number:
561-962-2679

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
751 PARK OF COMMERCE DR
Provider Second Line Business Practice Location Address:
SUITE 136
Provider Business Practice Location Address City Name:
BOCA RATON
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33487-3626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-575-2345
Provider Business Practice Location Address Fax Number:
561-962-2679
Provider Enumeration Date:
06/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DICKSON
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
ALAN
Authorized Official Title or Position:
VICE-PRESIDENT
Authorized Official Telephone Number:
561-271-1645

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 009414250 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1205830197 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 124666741 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 18666000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200830080 A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1205830197 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 138628000 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1458228 , issued by the state of ( ND ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1205830197 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1205830197 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1984825 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3079015 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001449545 0007 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100004910A , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1205830197 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1205830197-01 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2160068 . This is a "PK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 90292293 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000T4184 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01661614 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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