Provider Demographics
NPI:1518144179
Name:AMC SCHOOL APPAREL CENTERS
Entity Type:Organization
Organization Name:AMC SCHOOL APPAREL CENTERS
Other - Org Name:MARTINELLI'S
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARTINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-425-6287
Mailing Address - Street 1:3517 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2135
Mailing Address - Country:US
Mailing Address - Phone:708-425-6287
Mailing Address - Fax:708-425-6286
Practice Address - Street 1:3517 W 95TH ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2135
Practice Address - Country:US
Practice Address - Phone:708-425-6287
Practice Address - Fax:708-425-6286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL6082340001Medicare NSC