Provider Demographics
NPI:1780072116
Name:ACS MEDICAL LLC
Entity type:Organization
Organization Name:ACS MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:COAKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-421-4933
Mailing Address - Street 1:10538 JUSTIN DR
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-3755
Mailing Address - Country:US
Mailing Address - Phone:515-421-4933
Mailing Address - Fax:515-331-9038
Practice Address - Street 1:10538 JUSTIN DR
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-3755
Practice Address - Country:US
Practice Address - Phone:515-421-4933
Practice Address - Fax:515-331-9038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-08
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE6880520001Medicare NSC