Provider Demographics
NPI:1174796882
Name:A1A SERVICE & SUPPLIES, INC
Entity type:Organization
Organization Name:A1A SERVICE & SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-663-9129
Mailing Address - Street 1:6555 NW 36TH ST STE 311
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6975
Mailing Address - Country:US
Mailing Address - Phone:786-265-7980
Mailing Address - Fax:786-265-8438
Practice Address - Street 1:6555 NW 36TH ST STE 311
Practice Address - Street 2:
Practice Address - City:VIRGINIA GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33166-6975
Practice Address - Country:US
Practice Address - Phone:786-265-7980
Practice Address - Fax:786-265-8438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies