Provider Demographics
NPI:1932259470
Name:MCS GLOBAL MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:MCS GLOBAL MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNT EXECUTIVE
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:I
Authorized Official - Last Name:NWACHUKWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-664-0034
Mailing Address - Street 1:1900 N AUSTIN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-5010
Mailing Address - Country:US
Mailing Address - Phone:773-664-0034
Mailing Address - Fax:773-664-0035
Practice Address - Street 1:1900 N AUSTIN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-5010
Practice Address - Country:US
Practice Address - Phone:773-664-0034
Practice Address - Fax:773-664-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL203.000451332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL45494843001Medicaid
IL45494843001Medicaid