Provider Demographics
NPI:1689641813
Name:A & H STORES, INC.
Entity Type:Organization
Organization Name:A & H STORES, INC.
Other - Org Name:A & H MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:MR
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:HENDRICKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-520-0333
Mailing Address - Street 1:25022 104TH AVE SE
Mailing Address - Street 2:SUITE E
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98030-2822
Mailing Address - Country:US
Mailing Address - Phone:253-520-0333
Mailing Address - Fax:253-520-0444
Practice Address - Street 1:25022 104TH AVE SE
Practice Address - Street 2:SUITE E
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-2822
Practice Address - Country:US
Practice Address - Phone:253-520-0333
Practice Address - Fax:253-520-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6150205Medicaid
WA0252730006Medicare NSC