Provider Demographics
NPI:1952487621
Name:A & O SURGICAL SUPPLY CO, INC
Entity Type:Organization
Organization Name:A & O SURGICAL SUPPLY CO, INC
Other - Org Name:A & O SURGICAL SUPPLY CO INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-654-1882
Mailing Address - Street 1:266 E GUN HILL RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-2107
Mailing Address - Country:US
Mailing Address - Phone:718-654-1882
Mailing Address - Fax:718-231-4458
Practice Address - Street 1:266 E GUN HILL RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2107
Practice Address - Country:US
Practice Address - Phone:718-654-1882
Practice Address - Fax:718-231-4458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00322032Medicaid
NY00322032Medicaid