Provider Demographics
NPI:1467458240
Name:MEDSERV EQUIPMENT CORP
Entity Type:Organization
Organization Name:MEDSERV EQUIPMENT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:J. DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BESHOAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-359-4607
Mailing Address - Street 1:20066 N RAND RD
Mailing Address - Street 2:STE C
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-2030
Mailing Address - Country:US
Mailing Address - Phone:847-359-4607
Mailing Address - Fax:847-359-4650
Practice Address - Street 1:20066 N RAND RD
Practice Address - Street 2:STE C
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-2030
Practice Address - Country:US
Practice Address - Phone:847-359-4607
Practice Address - Fax:847-359-4650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-25
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203-000245332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL=========001Medicaid