Organization
ACE MEDICAL SUPPLY, INC
Active
Other names
Ace Forms & Systems
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANELLE D FORD (OWNER)
(260) 483-3516
Entity
Organization
Contact information
Practice address
6155 STONEY CREEK DR, FORT WAYNE, IN 46825-4409
(260) 483-3516
(260) 471-2797
Mailing address
6155 STONEY CREEK DR, FORT WAYNE, IN 46825-4409
(260) 483-3516
(260) 471-2797
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000212825
BLUE CROSS BLUE SHIELD
IN
05
—
026687600
—
MN
05
—
200255500A
—
KS
05
—
200310680A
—
IN
05
—
219865074A
—
GA
05
—
2337813
—
OH
01
—
2441973000
PASSPORT ADVANTAGE
KY
01
—
2626512
KENTUCKY PASSPORT
KY
05
—
6201052000
—
WV
05
—
626219000
—
MO
05
—
756968
—
AZ
05
—
82638200
—
WI
05
—
874370556
—
MI
05
—
90004821
—
KY
Enumeration date
02/28/2006
Last updated
02/03/2012
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