Provider Demographics
NPI:1730358607
Name:ABC MEDICAL SUPPLY LLC
Entity type:Organization
Organization Name:ABC MEDICAL SUPPLY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHENDRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:M PHARM
Authorized Official - Phone:919-413-2120
Mailing Address - Street 1:301 KEISLER DR
Mailing Address - Street 2:STE A
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-7018
Mailing Address - Country:US
Mailing Address - Phone:919-413-2120
Mailing Address - Fax:
Practice Address - Street 1:301 KEISLER DR
Practice Address - Street 2:STE A
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-7018
Practice Address - Country:US
Practice Address - Phone:919-413-2120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCIN PROCESS332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies