Provider Demographics
NPI:1205066396
Name:AID MEDICAL SUPPLY
Entity type:Organization
Organization Name:AID MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:DYMINSKIY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-478-0890
Mailing Address - Street 1:1613 NEWGATE CT
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-6850
Mailing Address - Country:US
Mailing Address - Phone:847-478-0890
Mailing Address - Fax:847-478-0443
Practice Address - Street 1:1613 NEWGATE CT
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-6850
Practice Address - Country:US
Practice Address - Phone:847-478-0890
Practice Address - Fax:847-478-0443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies