Provider Demographics
NPI:1104639087
Name:MA MED SUPPLY LLC
Entity type:Organization
Organization Name:MA MED SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:M
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-678-7875
Mailing Address - Street 1:555 N POINT CTR E STE 471
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8269
Mailing Address - Country:US
Mailing Address - Phone:800-678-7875
Mailing Address - Fax:800-678-7875
Practice Address - Street 1:555 N POINT CTR E STE 471
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-8269
Practice Address - Country:US
Practice Address - Phone:800-678-7875
Practice Address - Fax:800-678-7875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies