Provider Demographics
NPI:1497936983
Name:ANTHONY AKIDI
Entity Type:Organization
Organization Name:ANTHONY AKIDI
Other - Org Name:A2A MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:AKIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-622-9794
Mailing Address - Street 1:525 N CENTRAL AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-4236
Mailing Address - Country:US
Mailing Address - Phone:909-622-9794
Mailing Address - Fax:909-981-5368
Practice Address - Street 1:525 N CENTRAL AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4236
Practice Address - Country:US
Practice Address - Phone:909-622-9794
Practice Address - Fax:909-981-5368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48289332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6087470001Medicare NSC