Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Nursing Facility Supplies |
332BN1400X | 87 | All Other Suppliers |
| NPI # | 1235251059 |
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| LBN Legal business name | MEDICAL SUPPLY COMPANY OF ILLINOIS LLC | ||||
| Authorized official | SHERMAN DELLA - (CFO) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 04/04/2007 | ||||
| Last updated | 12/04/2007 - About 19 years ago | ||||
| Identifiers |
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