Provider Demographics
NPI:1356092472
Name:ALLSTAR MEDICAL SUPPLY CORPORATION
Entity Type:Organization
Organization Name:ALLSTAR MEDICAL SUPPLY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BONENFANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-677-1353
Mailing Address - Street 1:15 GLIDDEN RD STE 1-2
Mailing Address - Street 2:
Mailing Address - City:MOULTONBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03254-3697
Mailing Address - Country:US
Mailing Address - Phone:603-677-1353
Mailing Address - Fax:603-273-0160
Practice Address - Street 1:15 GLIDDEN RD STE 1-2
Practice Address - Street 2:
Practice Address - City:MOULTONBOROUGH
Practice Address - State:NH
Practice Address - Zip Code:03254-3697
Practice Address - Country:US
Practice Address - Phone:603-677-1353
Practice Address - Fax:603-273-0160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies