AMERICAN MEDICAL SUPPLIES INC

Provider Demographics

• NPI: 1205830197
• Name: AMERICAN MEDICAL SUPPLIES INC
• Entity Type: Organization
• Organization Name: AMERICAN MEDICAL SUPPLIES INC
• Other - Org Name: AMERICAN MEDICAL SUPPLIES, INC.
• Other - Org Type: Doing Business As
• Authorized Official - Title/Position: VICE-PRESIDENT
• Authorized Official - First Name: LAWRENCE
• Authorized Official - Middle Name: ALAN
• Authorized Official - Last Name: DICKSON
• Authorized Official - Phone: 561-271-1645
• Mailing Address - Street 1: 751 PARK OF COMMERCE DR
• Mailing Address - Street 2: SUITE 136
• Mailing Address - City: BOCA RATON
• Mailing Address - State: FL
• Mailing Address - Zip Code: 33487-3626
• Mailing Address - Country: US
• Mailing Address - Phone: 800-575-2345
• Mailing Address - Fax: 561-962-2679
• Practice Address - Street 1: 751 PARK OF COMMERCE DR
• Practice Address - Street 2: SUITE 136
• Practice Address - City: BOCA RATON
• Practice Address - State: FL
• Practice Address - Zip Code: 33487-3626
• Practice Address - Country: US
• Practice Address - Phone: 800-575-2345
• Practice Address - Fax: 561-962-2679
• EIN: <UNAVAIL>
• Is Organization Subpart?: Yes
• Parent Organization LBN: ALERE PHOENIX ACQ INC.
• Parent Organization TIN: <UNAVAIL>
• Enumeration Date: 2005-06-08
• Last Update Date: 2017-03-07

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies

Provider Identifiers

State	Identifier ID	ID Type	Issuer
AL	009414250	Medicaid
RI	1205830197	Medicaid
AR	124666741	Medicaid
ME	18666000	Medicaid
IN	200830080 A	Medicaid
MI	1205830197	Medicaid
MD	138628000	Medicaid
ND	1458228	Medicaid
MN	1205830197	Medicaid
NC	1205830197	Medicaid
LA	1984825	Medicaid
NH	3079015	Medicaid
PA	001449545 0007	Medicaid
KS	100004910A	Medicaid
ID	1205830197	Medicaid
CA	1205830197-01	Medicaid
	2160068	Other	PK
KY	90292293	Medicaid
NM	000T4184	Medicaid
NY	01661614	Medicaid
OH	0962178	Medicaid
MA	110104170A	Medicaid
SD	1205830197	Medicaid
OR	171764	Medicaid
OK	100800110 A	Medicaid
MO	1205830197	Medicaid
IL	1205830197	Medicaid
MT	1205830197	Medicaid
GU	1205830197	Medicaid
DE	1205830197	Medicaid
AZ	160169	Medicaid
GA	000796914X	Medicaid
MS	00440156	Medicaid
AK	1021868	Medicaid
CT	1205830197	Medicaid
NV	1205830197	Medicaid
NJ	6052509	Medicaid
FL	003352700	Medicaid
CO	98002637	Medicaid
SC	DME726	Medicaid
MD	138628000	Medicaid
ND	1458228	Medicaid
	0594900001	Medicare NSC