Provider Demographics
NPI:1174791651
Name:ABC HOME MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:ABC HOME MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-897-8588
Mailing Address - Street 1:250 N SUNNY SLOPE RD
Mailing Address - Street 2:STE 300
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-4809
Mailing Address - Country:US
Mailing Address - Phone:866-897-8588
Mailing Address - Fax:972-270-7282
Practice Address - Street 1:250 N SUNNY SLOPE RD
Practice Address - Street 2:STE 300
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-4809
Practice Address - Country:US
Practice Address - Phone:866-897-8588
Practice Address - Fax:972-270-7282
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABC HOME MEDICAL SUPPLY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies