Provider Demographics
NPI:1326044157
Name:AMERICAN MEDICAL SUPPLY COMPANY
Entity type:Organization
Organization Name:AMERICAN MEDICAL SUPPLY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOHNNA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:MAERTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-732-9111
Mailing Address - Street 1:314 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:TX
Mailing Address - Zip Code:78934-2453
Mailing Address - Country:US
Mailing Address - Phone:979-732-9111
Mailing Address - Fax:
Practice Address - Street 1:314 WALNUT ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:TX
Practice Address - Zip Code:78934-2453
Practice Address - Country:US
Practice Address - Phone:979-732-9111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX0009135332B00000X
TX0029598A332BX2000X
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX519805OtherBCBSTX - DME
TX519805OtherBCBSTX - DME