Provider Demographics
NPI:1366681363
Name:AHC MEDICAL SUPPLY, LLC
Entity Type:Organization
Organization Name:AHC MEDICAL SUPPLY, LLC
Other - Org Name:AHC MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:EMMETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-670-5700
Mailing Address - Street 1:5323 MURRAY BLVD
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84123-6973
Mailing Address - Country:US
Mailing Address - Phone:801-713-3254
Mailing Address - Fax:888-542-6662
Practice Address - Street 1:1497 E SKYLINE DR
Practice Address - Street 2:
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-4837
Practice Address - Country:US
Practice Address - Phone:801-713-3254
Practice Address - Fax:888-542-6662
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVANCED HEALTH CARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-13
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies