Provider Demographics
NPI:1922329168
Name:ARMOR MEDICAL SUPPLY CHICAGO WEST
Entity Type:Organization
Organization Name:ARMOR MEDICAL SUPPLY CHICAGO WEST
Other - Org Name:ARMOR MEDICAL CHICAGO WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KIMBREL
Authorized Official - Middle Name:DWANE
Authorized Official - Last Name:STEPHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-557-5074
Mailing Address - Street 1:2923 W JACKSON BLVD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3635
Mailing Address - Country:US
Mailing Address - Phone:708-557-5074
Mailing Address - Fax:815-469-2398
Practice Address - Street 1:2923 W JACKSON BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3635
Practice Address - Country:US
Practice Address - Phone:708-557-5074
Practice Address - Fax:815-469-2398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies