Provider Demographics
NPI:1194972398
Name:AMERICAN HEALTH AND MEDICAL SUPPLY SERVICES LLC
Entity type:Organization
Organization Name:AMERICAN HEALTH AND MEDICAL SUPPLY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:IJEOMA
Authorized Official - Last Name:UNAEGBU
Authorized Official - Suffix:
Authorized Official - Credentials:BS NUTRITION/MNGT
Authorized Official - Phone:202-465-4844
Mailing Address - Street 1:2004 RHODE ISLAND AVE NE
Mailing Address - Street 2:SUITE# 200
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-2835
Mailing Address - Country:US
Mailing Address - Phone:202-465-4844
Mailing Address - Fax:202-558-6421
Practice Address - Street 1:2004 RHODE ISLAND AVE NE
Practice Address - Street 2:SUITE# 200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2835
Practice Address - Country:US
Practice Address - Phone:202-465-4844
Practice Address - Fax:202-558-6421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-19
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC332B00000X, 332BC3200X, 332BN1400X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
6139060001Medicare NSC