Provider Demographics
NPI:1790832558
Name:MEDICAL SUPPORT SERVICES INC
Entity type:Organization
Organization Name:MEDICAL SUPPORT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:B
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-294-4281
Mailing Address - Street 1:1917 SHIRLANE PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87112-4738
Mailing Address - Country:US
Mailing Address - Phone:505-294-4281
Mailing Address - Fax:505-294-4227
Practice Address - Street 1:1917 SHIRLANE PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87112-4738
Practice Address - Country:US
Practice Address - Phone:505-294-4281
Practice Address - Fax:505-294-4227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1213900001Medicare ID - Type Unspecified