Provider Demographics
NPI:1043240955
Name:RITZ MEDICAL SUPPLIES, INC
Entity Type:Organization
Organization Name:RITZ MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ETUKUDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-283-4800
Mailing Address - Street 1:22113 GOVERNORS HWY
Mailing Address - Street 2:
Mailing Address - City:RICHTON PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60471-1249
Mailing Address - Country:US
Mailing Address - Phone:708-283-4800
Mailing Address - Fax:708-283-4667
Practice Address - Street 1:22113 GOVERNORS HWY
Practice Address - Street 2:
Practice Address - City:RICHTON PARK
Practice Address - State:IL
Practice Address - Zip Code:60471-1249
Practice Address - Country:US
Practice Address - Phone:708-283-4800
Practice Address - Fax:708-283-4667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-04
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203000510332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001630364OtherBLUE CROSS BLUE SHEILD
IL0001630364OtherBLUE CROSS BLUE SHEILD
IL4310000001Medicare NSC