Provider Demographics
NPI:1245831197
Name:THE LIFESUPPLIES INC
Entity type:Organization
Organization Name:THE LIFESUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:OGOCHUKWU
Authorized Official - Last Name:NWANDU
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:708-259-0811
Mailing Address - Street 1:26117 S COUNTYFAIR DR
Mailing Address - Street 2:
Mailing Address - City:MONEE
Mailing Address - State:IL
Mailing Address - Zip Code:60449-8783
Mailing Address - Country:US
Mailing Address - Phone:708-259-0811
Mailing Address - Fax:708-441-2131
Practice Address - Street 1:26117 S COUNTYFAIR DR
Practice Address - Street 2:
Practice Address - City:MONEE
Practice Address - State:IL
Practice Address - Zip Code:60449-8783
Practice Address - Country:US
Practice Address - Phone:708-259-0811
Practice Address - Fax:708-441-2131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies