Provider Demographics
NPI:1336449768
Name:A&E MEDICAL SUPPLIES LLC.
Entity Type:Organization
Organization Name:A&E MEDICAL SUPPLIES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:LANCE
Authorized Official - Last Name:MALALIS
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:808-384-8184
Mailing Address - Street 1:98-1794 NAHELE ST.
Mailing Address - Street 2:
Mailing Address - City:ALEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701
Mailing Address - Country:US
Mailing Address - Phone:808-384-8184
Mailing Address - Fax:
Practice Address - Street 1:98-1794 NAHELE ST.
Practice Address - Street 2:
Practice Address - City:ALEA
Practice Address - State:HI
Practice Address - Zip Code:96701
Practice Address - Country:US
Practice Address - Phone:808-384-8184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies