Provider Demographics
NPI:1033161005
Name:AAA MEDICAL & INDUSTRIAL GASES, INC.
Entity type:Organization
Organization Name:AAA MEDICAL & INDUSTRIAL GASES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MEYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-524-3678
Mailing Address - Street 1:1215 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:METROPOLIS
Mailing Address - State:IL
Mailing Address - Zip Code:62960-2433
Mailing Address - Country:US
Mailing Address - Phone:618-524-3678
Mailing Address - Fax:618-524-4953
Practice Address - Street 1:1215 W 10TH ST
Practice Address - Street 2:
Practice Address - City:METROPOLIS
Practice Address - State:IL
Practice Address - Zip Code:62960-2433
Practice Address - Country:US
Practice Address - Phone:618-524-3678
Practice Address - Fax:618-524-4953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0007715000OtherBLUE CROSS BLUE SHIELD
IL=========001Medicaid
IL0239130001Medicare NSC