Provider Demographics
NPI:1891950960
Name:M & M SUPPLIES, INC.
Entity Type:Organization
Organization Name:M & M SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-520-9535
Mailing Address - Street 1:251 MILWAUKEE AVE
Mailing Address - Street 2:STE 1013
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-2809
Mailing Address - Country:US
Mailing Address - Phone:877-520-9535
Mailing Address - Fax:847-520-9565
Practice Address - Street 1:251 MILWAUKEE AVE
Practice Address - Street 2:STE 1013
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-2809
Practice Address - Country:US
Practice Address - Phone:877-520-9535
Practice Address - Fax:847-520-9565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203.001020332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL6176860001Medicare NSC