Provider Demographics
NPI:1598469280
Name:OPEN ARMS MEDICAL SUPPLY COMPANY, LLC
Entity Type:Organization
Organization Name:OPEN ARMS MEDICAL SUPPLY COMPANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-644-0542
Mailing Address - Street 1:109 E 47TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60653-3806
Mailing Address - Country:US
Mailing Address - Phone:312-644-0542
Mailing Address - Fax:312-471-8913
Practice Address - Street 1:109 E 47TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60653-3806
Practice Address - Country:US
Practice Address - Phone:312-644-0542
Practice Address - Fax:312-471-8913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies