Provider Demographics
NPI:1114318276
Name:A-KIDS FIRST MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:A-KIDS FIRST MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:P
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-290-3895
Mailing Address - Street 1:1301 BRANDEN LN
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-8924
Mailing Address - Country:US
Mailing Address - Phone:630-290-3895
Mailing Address - Fax:630-855-6734
Practice Address - Street 1:1301 BRANDEN LN
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-8924
Practice Address - Country:US
Practice Address - Phone:630-290-3895
Practice Address - Fax:630-855-6734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203.001209332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========Medicaid