1912074022 NPI number — A & A MEDICAL SUPPLY, CORP

Table of content: (NPI 1912074022)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912074022 NPI number — A & A MEDICAL SUPPLY, CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A & A MEDICAL SUPPLY, CORP
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:
1912074022
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 MAIN ST
Provider Second Line Business Mailing Address:
UNIT C
Provider Business Mailing Address City Name:
ACTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01720-3575
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-635-0002
Provider Business Mailing Address Fax Number:
978-263-0821

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 MAIN ST
Provider Second Line Business Practice Location Address:
UNIT C
Provider Business Practice Location Address City Name:
ACTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01720-3575
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-635-0002
Provider Business Practice Location Address Fax Number:
978-263-0821
Provider Enumeration Date:
11/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CUTLER
Authorized Official First Name:
JANE
Authorized Official Middle Name:
ANNE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
978-635-0002

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: 20485 . This is a "BMC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 704179 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 390854 . This is a "BLUECROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0021006 . This is a "NEIGHBORHOOD HLTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1539256 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 686311 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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