Provider Demographics
NPI:1720372071
Name:HEALTHCARE MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:HEALTHCARE MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-225-1080
Mailing Address - Street 1:765 N 1890 W
Mailing Address - Street 2:SUITE 13
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84601-1323
Mailing Address - Country:US
Mailing Address - Phone:801-225-1080
Mailing Address - Fax:
Practice Address - Street 1:765 N 1890 W
Practice Address - Street 2:SUITE 13
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84601-1323
Practice Address - Country:US
Practice Address - Phone:801-225-1080
Practice Address - Fax:801-225-1069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-04
Last Update Date:2011-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies