Provider Demographics
NPI:1861846834
Name:A & M SUPPLY INC.
Entity Type:Organization
Organization Name:A & M SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCUS
Authorized Official - Middle Name:JOMAR
Authorized Official - Last Name:USON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-747-0704
Mailing Address - Street 1:4917 TOWNSEND AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-2235
Mailing Address - Country:US
Mailing Address - Phone:323-747-0704
Mailing Address - Fax:
Practice Address - Street 1:4875 EAGLE ROCK BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-2632
Practice Address - Country:US
Practice Address - Phone:323-747-0704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0002895154-0001-0332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies