Provider Demographics
NPI:1396041810
Name:ASAP MEDICAL SUPPLY
Entity Type:Organization
Organization Name:ASAP MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:SHONKWILER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-928-3622
Mailing Address - Street 1:396 FARVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4630
Mailing Address - Country:US
Mailing Address - Phone:973-928-3622
Mailing Address - Fax:973-928-3621
Practice Address - Street 1:152 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-1550
Practice Address - Country:US
Practice Address - Phone:973-928-3622
Practice Address - Fax:973-928-3621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies