Provider Demographics
NPI:1386630200
Name:AFFORDABLE MEDICAL EQUIPMENT SOLUTION
Entity Type:Organization
Organization Name:AFFORDABLE MEDICAL EQUIPMENT SOLUTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MADHU
Authorized Official - Middle Name:M
Authorized Official - Last Name:MATHEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-936-9376
Mailing Address - Street 1:3223 SUNSET BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-3200
Mailing Address - Country:US
Mailing Address - Phone:803-936-9376
Mailing Address - Fax:803-936-9872
Practice Address - Street 1:6930 BONNEVAL RD
Practice Address - Street 2:SUITE 3
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-6012
Practice Address - Country:US
Practice Address - Phone:904-674-2100
Practice Address - Fax:904-674-2105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-26
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312127332B00000X
FL326736332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL271000OtherAMERIGROUP
FLR9571OtherBCBS
FL5134040001Medicare NSC