Provider Demographics
NPI:1407326416
Name:AFFORDABLE MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:AFFORDABLE MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-890-2094
Mailing Address - Street 1:7200 ALBEMARLE RD STE E
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-8110
Mailing Address - Country:US
Mailing Address - Phone:980-613-8496
Mailing Address - Fax:704-910-3995
Practice Address - Street 1:7200 ALBEMARLE RD STE E
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-8110
Practice Address - Country:US
Practice Address - Phone:704-890-2094
Practice Address - Fax:704-910-3995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies