Provider Demographics
NPI:1295738284
Name:A & A MEDICAL SUPPLY COMPANY
Entity type:Organization
Organization Name:A & A MEDICAL SUPPLY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKHAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAKHTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-526-9323
Mailing Address - Street 1:146 CHARTLEY DR
Mailing Address - Street 2:STE 100
Mailing Address - City:REISTERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21136-2331
Mailing Address - Country:US
Mailing Address - Phone:410-526-9323
Mailing Address - Fax:410-526-3375
Practice Address - Street 1:146 CHARTLEY DR
Practice Address - Street 2:STE 100
Practice Address - City:REISTERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21136-2331
Practice Address - Country:US
Practice Address - Phone:410-526-9323
Practice Address - Fax:410-526-3375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD510705900Medicaid
MD4559700001Medicare NSC