Provider Demographics
NPI:1629072665
Name:AIRLINE DRUG INC.
Entity Type:Organization
Organization Name:AIRLINE DRUG INC.
Other - Org Name:LOUIS & CLARK MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARK
Authorized Official - Middle Name:E
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:413-737-7456
Mailing Address - Street 1:309 EAST STREET
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01104-2259
Mailing Address - Country:US
Mailing Address - Phone:413-737-7456
Mailing Address - Fax:413-737-3814
Practice Address - Street 1:309 EAST ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-2259
Practice Address - Country:US
Practice Address - Phone:413-737-7456
Practice Address - Fax:413-781-0642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-08
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA283154OtherBCBS
MA1513508Medicaid
MA20058OtherHEALTH NET PLAN
MA1513508Medicaid