Provider Demographics
NPI:1730471418
Name:CMN MEDICAL SYSTEMS, CORP
Entity Type:Organization
Organization Name:CMN MEDICAL SYSTEMS, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:NUCUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-904-9965
Mailing Address - Street 1:1155 N MAIN ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:GLENDALE HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60139-3508
Mailing Address - Country:US
Mailing Address - Phone:888-503-1505
Mailing Address - Fax:815-301-8229
Practice Address - Street 1:1155 N MAIN ST
Practice Address - Street 2:SUITE E
Practice Address - City:GLENDALE HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60139-3508
Practice Address - Country:US
Practice Address - Phone:888-503-1505
Practice Address - Fax:815-301-8229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies