Provider Demographics
NPI:1992255814
Name:AAA MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:AAA MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:OFFERLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:260-602-9574
Mailing Address - Street 1:11718 WOODSTREAM RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-1908
Mailing Address - Country:US
Mailing Address - Phone:260-602-9574
Mailing Address - Fax:
Practice Address - Street 1:6155 STONEY CREEK DR
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-4409
Practice Address - Country:US
Practice Address - Phone:260-602-9574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1840206163332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies