Provider Demographics
NPI:1700208592
Name:ALL AMERICAN MEDICAL SUPPLIES, LLC
Entity Type:Organization
Organization Name:ALL AMERICAN MEDICAL SUPPLIES, LLC
Other - Org Name:ALL AMERICAN MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LETKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-455-3862
Mailing Address - Street 1:3640 ENTERPRISE WAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-6616
Mailing Address - Country:US
Mailing Address - Phone:305-455-3862
Mailing Address - Fax:954-436-4263
Practice Address - Street 1:719 DURHAM RD
Practice Address - Street 2:
Practice Address - City:RIEGELSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18077
Practice Address - Country:US
Practice Address - Phone:866-984-3048
Practice Address - Fax:954-436-4263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-13
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6000008414332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102817139Medicaid