Provider Demographics
NPI:1437543212
Name:ASAASA MEDICAL SUPPLY & HOME OXYGEN
Entity Type:Organization
Organization Name:ASAASA MEDICAL SUPPLY & HOME OXYGEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:N
Authorized Official - Last Name:IWUCHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-319-7397
Mailing Address - Street 1:8430 UNIVERSITY EXEC PARK DR
Mailing Address - Street 2:SUITE 670
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1350
Mailing Address - Country:US
Mailing Address - Phone:704-526-0426
Mailing Address - Fax:704-526-0440
Practice Address - Street 1:8430 UNIVERSITY EXEC PARK DR
Practice Address - Street 2:SUITE 670
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1350
Practice Address - Country:US
Practice Address - Phone:704-526-0426
Practice Address - Fax:704-526-0440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-19
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies