Provider Demographics
NPI:1326219973
Name:ALLIED MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:ALLIED MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-708-2686
Mailing Address - Street 1:3433 N ROCK RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-1376
Mailing Address - Country:US
Mailing Address - Phone:316-634-2777
Mailing Address - Fax:316-634-2785
Practice Address - Street 1:3433 N ROCK RD
Practice Address - Street 2:SUITE 103
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-1376
Practice Address - Country:US
Practice Address - Phone:316-634-2777
Practice Address - Fax:316-634-2785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies