Provider Demographics
NPI:1831176437
Name:M&M MEDICAL SUPPLY INC.
Entity type:Organization
Organization Name:M&M MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:COONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-966-3290
Mailing Address - Street 1:107 UXBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MENDON
Mailing Address - State:MA
Mailing Address - Zip Code:01756-1223
Mailing Address - Country:US
Mailing Address - Phone:508-966-3290
Mailing Address - Fax:508-464-0332
Practice Address - Street 1:107 UXBRIDGE RD
Practice Address - Street 2:
Practice Address - City:MENDON
Practice Address - State:MA
Practice Address - Zip Code:01756-1223
Practice Address - Country:US
Practice Address - Phone:508-966-3290
Practice Address - Fax:508-464-0332
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
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
MA1540301Medicaid
MA4356540001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER