Provider Demographics
NPI:1316138464
Name:AMERICAN MEDICAL SUPPLY INCORPORATED
Entity type:Organization
Organization Name:AMERICAN MEDICAL SUPPLY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LANE
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:LINDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-963-4086
Mailing Address - Street 1:4714 GLEN MOOR WAY
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-9588
Mailing Address - Country:US
Mailing Address - Phone:765-963-4086
Mailing Address - Fax:
Practice Address - Street 1:4714 GLEN MOOR WAY
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-9588
Practice Address - Country:US
Practice Address - Phone:765-963-4086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies