Provider Demographics
NPI:1245773423
Name:A & G MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:A & G MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EBENE
Authorized Official - Middle Name:
Authorized Official - Last Name:AKPAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-317-7994
Mailing Address - Street 1:18019 DIXIE HWY
Mailing Address - Street 2:STE#1A
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-1733
Mailing Address - Country:US
Mailing Address - Phone:773-317-7994
Mailing Address - Fax:
Practice Address - Street 1:18019 DIXIE HWY
Practice Address - Street 2:STE#1A
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-1733
Practice Address - Country:US
Practice Address - Phone:773-317-7994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies