Provider Demographics
NPI:1568013746
Name:ARBOR MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:ARBOR MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ENEFIOK
Authorized Official - Middle Name:
Authorized Official - Last Name:EKONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-664-5259
Mailing Address - Street 1:4533 ARBOR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1362
Mailing Address - Country:US
Mailing Address - Phone:630-664-5259
Mailing Address - Fax:
Practice Address - Street 1:4533 ARBOR VIEW DR
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1362
Practice Address - Country:US
Practice Address - Phone:630-664-5259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies