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Organization

ADMIRAL MEDICAL SUPPLY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RASHARD GRAVES (OWNER)
(317) 641-3174
Entity
Organization

Contact information

Practice address
2511 E 46TH ST STE Q7, INDIANAPOLIS, IN 46205-2461
(317) 641-3174
(317) 545-1877
Mailing address
2511 E 46TH ST STE Q7, INDIANAPOLIS, IN 46205-2461
(317) 641-3174
(317) 545-1877

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0119124416
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200482300
IN
05
200921980
IN
Enumeration date
04/06/2006
Last updated
05/20/2009
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