Provider Demographics
NPI:1821232737
Name:DELTA MEDICAL FIRE & SAFETY SUPPLY, INC
Entity Type:Organization
Organization Name:DELTA MEDICAL FIRE & SAFETY SUPPLY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREASSEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:907-895-2020
Mailing Address - Street 1:PO BOX 389
Mailing Address - Street 2:MILE 266.5 RICHARDSON HIGHWAY
Mailing Address - City:DELTA JUNCTION
Mailing Address - State:AK
Mailing Address - Zip Code:99737-0389
Mailing Address - Country:US
Mailing Address - Phone:907-895-2020
Mailing Address - Fax:907-895-2220
Practice Address - Street 1:MILE 266.5 RICHARDSON HWY
Practice Address - Street 2:
Practice Address - City:DELTA JUNCTION
Practice Address - State:AK
Practice Address - Zip Code:99737-0389
Practice Address - Country:US
Practice Address - Phone:907-895-2020
Practice Address - Fax:907-895-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6483050001Medicare NSC