Provider Demographics
NPI:1891878856
Name:A-Z & MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:A-Z & MEDICAL SUPPLY INC
Other - Org Name:A-Z & MEDICAL SUPPLY INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPATINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-718-1833
Mailing Address - Street 1:1141B S ARLINGTON HEIGHTS RD # B
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-3140
Mailing Address - Country:US
Mailing Address - Phone:847-718-1833
Mailing Address - Fax:847-718-1197
Practice Address - Street 1:1141B S ARLINGTON HEIGHTS RD # B
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3140
Practice Address - Country:US
Practice Address - Phone:847-718-1833
Practice Address - Fax:847-718-1197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203000799332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL5720440001Medicare NSC