Provider Demographics
NPI:1952663957
Name:AMIL LLC
Entity Type:Organization
Organization Name:AMIL LLC
Other - Org Name:GUARDIAN SPORTS AND ORTHOPEDIC SUPPLY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:M
Authorized Official - Last Name:LIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-454-3307
Mailing Address - Street 1:21720 LORAIN RD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44126-3329
Mailing Address - Country:US
Mailing Address - Phone:440-454-3307
Mailing Address - Fax:
Practice Address - Street 1:28107 PRESTON PL
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-3836
Practice Address - Country:US
Practice Address - Phone:440-454-3307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies