Provider Demographics
NPI:1922544485
Name:A1 MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:A1 MEDICAL SUPPLIES
Other - Org Name:A1 FINGERPRINTING & DRUG SCREENING, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-782-8986
Mailing Address - Street 1:3643 CORTEZ RD W
Mailing Address - Street 2:SUITE 130 W
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-3154
Mailing Address - Country:US
Mailing Address - Phone:941-782-8986
Mailing Address - Fax:
Practice Address - Street 1:3643 CORTEZ RD W
Practice Address - Street 2:SUITE 130 W
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3154
Practice Address - Country:US
Practice Address - Phone:941-782-8986
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-09
Last Update Date:2017-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies