Provider Demographics
NPI:1003862681
Name:MED HELP MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:MED HELP MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHAROV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-972-8028
Mailing Address - Street 1:12611 N 103RD AVE
Mailing Address - Street 2:SUITE 'D'
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85351-3422
Mailing Address - Country:US
Mailing Address - Phone:623-972-8028
Mailing Address - Fax:623-972-0265
Practice Address - Street 1:12611 N 103RD AVE
Practice Address - Street 2:SUITE 'D'
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85351-3422
Practice Address - Country:US
Practice Address - Phone:623-972-8028
Practice Address - Fax:623-972-0265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1131039332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ5341400001Medicare ID - Type Unspecified