Provider Demographics
NPI:1184650574
Name:ANOVA MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:ANOVA MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OLGA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUPINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-283-0206
Mailing Address - Street 1:286 WASHINGTON AVENUE EXT STE 204
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-6303
Mailing Address - Country:US
Mailing Address - Phone:518-283-0206
Mailing Address - Fax:518-283-1628
Practice Address - Street 1:286 WASHINGTON AVENUE EXT STE 204
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-6303
Practice Address - Country:US
Practice Address - Phone:518-283-0206
Practice Address - Fax:518-283-1628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2023-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5865340001Medicare NSC