1831545565 NPI number — ABC HOME MEDICAL SUPPLY, INC.

Table of content: (NPI 1831545565)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831545565 NPI number — ABC HOME MEDICAL SUPPLY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABC HOME MEDICAL SUPPLY, 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:
Provider Other Organization Name Type Code:
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:
1831545565
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 674553
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DETROIT
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48267-4553
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-643-2850
Provider Business Mailing Address Fax Number:
720-452-9034

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7302 S ALTON WAY STE 4-K
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CENTENNIAL
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80112-2313
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-643-2850
Provider Business Practice Location Address Fax Number:
720-452-9034
Provider Enumeration Date:
05/12/2016

Additional Information

Authorized Official

Authorized Official Last Name:
VESTAL
Authorized Official First Name:
EMILY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT AND DIRECTOR
Authorized Official Telephone Number:
866-897-8588

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: 30003943100002 , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 19155107 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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