Provider Demographics
NPI:1568406916
Name:A 1 A MEDICAL SUPPLY, INC
Entity Type:Organization
Organization Name:A 1 A MEDICAL SUPPLY, INC
Other - Org Name:A 1 MEDICAL SUPPLY, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:MEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-987-7800
Mailing Address - Street 1:101 CHESTNUT STREET #120
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877
Mailing Address - Country:US
Mailing Address - Phone:301-987-7800
Mailing Address - Fax:301-987-9002
Practice Address - Street 1:101 CHESTNUT STREET #120
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877
Practice Address - Country:US
Practice Address - Phone:301-987-7800
Practice Address - Fax:301-987-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD410519200Medicaid
DC038359500Medicaid
316053OtherAMERIGROUP
VA1568406916Medicaid
MD5739370001Medicare NSC