Provider Demographics
NPI:1326282575
Name:AETNA MEDICAL SUPPLIES USA INC
Entity Type:Organization
Organization Name:AETNA MEDICAL SUPPLIES USA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NWAEFULU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-460-2311
Mailing Address - Street 1:401 W ABRAM ST STE B
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-1059
Mailing Address - Country:US
Mailing Address - Phone:817-460-2311
Mailing Address - Fax:817-460-2344
Practice Address - Street 1:401 W ABRAM ST STE B
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-1059
Practice Address - Country:US
Practice Address - Phone:817-460-2311
Practice Address - Fax:817-460-2344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies