Provider Demographics
NPI:1194070433
Name:AMD MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:AMD MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGHIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-598-5727
Mailing Address - Street 1:2557 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-9003
Mailing Address - Country:US
Mailing Address - Phone:718-598-5727
Mailing Address - Fax:
Practice Address - Street 1:2557 BOSTON RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-9003
Practice Address - Country:US
Practice Address - Phone:718-598-5727
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-23
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies