Provider Demographics
NPI:1316271174
Name:DELTA MEDICAL SUPPLY COMPANY
Entity type:Organization
Organization Name:DELTA MEDICAL SUPPLY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:OGHALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-400-9156
Mailing Address - Street 1:86 TIMBER TRAILS CT
Mailing Address - Street 2:
Mailing Address - City:GILBERTS
Mailing Address - State:IL
Mailing Address - Zip Code:60136-4060
Mailing Address - Country:US
Mailing Address - Phone:630-400-9156
Mailing Address - Fax:847-742-8657
Practice Address - Street 1:86 TIMBER TRAILS CT
Practice Address - Street 2:
Practice Address - City:GILBERTS
Practice Address - State:IL
Practice Address - Zip Code:60136-4060
Practice Address - Country:US
Practice Address - Phone:630-400-9156
Practice Address - Fax:847-742-8657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies