Provider Demographics
NPI:1902633407
Name:A AND S HOME MEDICAL SUPPLY
Entity type:Organization
Organization Name:A AND S HOME MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SUNTUKUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:JARJOU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:913-832-9830
Mailing Address - Street 1:1936 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66101-1705
Mailing Address - Country:US
Mailing Address - Phone:913-832-9830
Mailing Address - Fax:
Practice Address - Street 1:1936 N 5TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66101-1705
Practice Address - Country:US
Practice Address - Phone:913-832-9830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies