Organization
BETTER BODY BOOT CAMP INC
Active
Other names
DS Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL SUSSAN (SALES)
(847) 323-0326
Entity
Organization
Contact information
Practice address
23280 W LONE TREE LN, LAKE ZURICH, IL 60047-9063
(847) 323-0326
Mailing address
23280 W LONE TREE LN, LAKE ZURICH, IL 60047-9063
(847) 323-0326
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
1043577935
IL
305R00000X
Preferred Provider Organization
1043577935
IL
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1043577935
IL
332BN1400X
Nursing Facility Supplies (DME)
1043577935
IL
3336M0002X
Mail Order Pharmacy
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Other
Enumeration date
04/16/2012
Last updated
08/17/2012
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