Organization
A & A MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KILEY ANN RUSSELL (SENIOR DIRECTOR OF PAYOR RELATIONS)
(629) 252-8211
Entity
Organization
Contact information
Practice address
5875 HARPER RD, SOLON, OH 44139-1832
(440) 543-4645
(800) 619-9009
Mailing address
9495 WINNETKA AVE N STE 200, BROOKLYN PARK, MN 55445-1618
(629) 282-8211
(763) 255-3972
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
OH
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000510295
ANTHEM BC/BS
OH
05
—
2676199
—
OH
01
—
378914
WELLCARE
OH
01
—
742189
BUCKEYE
OH
Enumeration date
06/05/2006
Last updated
04/17/2024
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