Provider Demographics
NPI:1710544895
Name:ASSURED MEDICAL SUPPLY, INC.
Entity Type:Organization
Organization Name:ASSURED MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-487-0084
Mailing Address - Street 1:23541 RIDGE ROUTE DR STE A
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1500
Mailing Address - Country:US
Mailing Address - Phone:949-487-0084
Mailing Address - Fax:949-487-0083
Practice Address - Street 1:1665 RAINBOW DR STE 7
Practice Address - Street 2:
Practice Address - City:BULLHEAD CITY
Practice Address - State:AZ
Practice Address - Zip Code:86442
Practice Address - Country:US
Practice Address - Phone:866-487-0084
Practice Address - Fax:866-487-0083
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASSURED MEDICAL SUPPLY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-23
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies