Provider Demographics
NPI:1740285972
Name:MEGA MEDICAL SUPPLY, INC.
Entity type:Organization
Organization Name:MEGA MEDICAL SUPPLY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:I
Authorized Official - Last Name:BARASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-384-0444
Mailing Address - Street 1:8118 N MILWAUKEE AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-2836
Mailing Address - Country:US
Mailing Address - Phone:847-384-0444
Mailing Address - Fax:847-384-0555
Practice Address - Street 1:8118 N MILWAUKEE AVE
Practice Address - Street 2:STE 102
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-2836
Practice Address - Country:US
Practice Address - Phone:847-384-0444
Practice Address - Fax:847-384-0555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4917840001Medicare ID - Type UnspecifiedMEDICARE