Provider Demographics
NPI:1538450481
Name:BASIC MEDICAL SUPPLIES, INC
Entity type:Organization
Organization Name:BASIC MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:CHAM
Authorized Official - Last Name:BOADU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-335-6112
Mailing Address - Street 1:26814 N 24TH LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-8741
Mailing Address - Country:US
Mailing Address - Phone:480-335-6112
Mailing Address - Fax:480-626-2923
Practice Address - Street 1:2316 W BETHANY HOME RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-1850
Practice Address - Country:US
Practice Address - Phone:480-335-6112
Practice Address - Fax:480-626-2923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies