Provider Demographics
NPI:1639349566
Name:ACS PRODUCTS, INC.
Entity Type:Organization
Organization Name:ACS PRODUCTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CFO
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MICKLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-329-7984
Mailing Address - Street 1:250 WILLIAMS STREET, NW
Mailing Address - Street 2:TLC PROGRAM MANAGER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303-1002
Mailing Address - Country:US
Mailing Address - Phone:404-929-6989
Mailing Address - Fax:404-327-6404
Practice Address - Street 1:3016 GEORGIA ST.
Practice Address - Street 2:
Practice Address - City:LOUISIANA
Practice Address - State:MO
Practice Address - Zip Code:63353-2800
Practice Address - Country:US
Practice Address - Phone:573-754-5511
Practice Address - Fax:573-754-3933
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN CANCER SOCIETY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-06
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO4826-04332B00000X
MO332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO5303940001Medicare NSC