Provider Demographics
NPI:1720243512
Name:ANB MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:ANB MEDICAL SUPPLY LLC
Other - Org Name:ALLEN N BLUMENTHAL SOL MBR
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER MBR
Authorized Official - Prefix:
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:N
Authorized Official - Last Name:BLUMENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-391-1140
Mailing Address - Street 1:615 POPLAR ROAD
Mailing Address - Street 2:
Mailing Address - City:RIVERVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-6430
Mailing Address - Country:US
Mailing Address - Phone:201-391-1140
Mailing Address - Fax:201-391-7973
Practice Address - Street 1:615 POPLAR ROAD
Practice Address - Street 2:
Practice Address - City:RIVERVALE
Practice Address - State:NJ
Practice Address - Zip Code:07675-6430
Practice Address - Country:US
Practice Address - Phone:201-391-1140
Practice Address - Fax:201-391-7973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment