Provider Demographics
NPI:1689013914
Name:MULLANEY MEDICAL, INC
Entity Type:Organization
Organization Name:MULLANEY MEDICAL, INC
Other - Org Name:MULLANEY'S MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDETN
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:MULLANEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:513-587-6201
Mailing Address - Street 1:1775 N SHERMAN DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46218-4500
Mailing Address - Country:US
Mailing Address - Phone:317-495-9461
Mailing Address - Fax:317-495-9462
Practice Address - Street 1:1775 N SHERMAN DR
Practice Address - Street 2:SUITE A
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46218-4500
Practice Address - Country:US
Practice Address - Phone:317-495-9461
Practice Address - Fax:317-495-9462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies