Provider Demographics
NPI:1467703280
Name:ABAMA MEDICAL SUPPLY, INC
Entity Type:Organization
Organization Name:ABAMA MEDICAL SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:OKSANA
Authorized Official - Middle Name:ALEKSANDROVNA
Authorized Official - Last Name:VELITSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-266-3573
Mailing Address - Street 1:12665 W 52ND AVE
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1805
Mailing Address - Country:US
Mailing Address - Phone:720-266-3573
Mailing Address - Fax:303-534-1757
Practice Address - Street 1:12665 W 52ND AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1805
Practice Address - Country:US
Practice Address - Phone:720-266-3573
Practice Address - Fax:303-534-1757
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies