Provider Demographics
NPI:1952519035
Name:A&B MEDICAL SUPPLY, LLC
Entity type:Organization
Organization Name:A&B MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:ROGER
Authorized Official - Last Name:BIEGANEK
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:320-249-3226
Mailing Address - Street 1:5854 PLEASANT LN
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-0621
Mailing Address - Country:US
Mailing Address - Phone:320-249-3226
Mailing Address - Fax:
Practice Address - Street 1:5854 PLEASANT LN
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-0621
Practice Address - Country:US
Practice Address - Phone:320-249-3226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies