Organization
ALLIED MEDICAL SUPPLY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODORE UBANWA (PRESIDENT)
(973) 799-0992
Entity
Organization
Contact information
Practice address
370 W MARKET ST, NEWARK, NJ 07107-3040
(973) 799-0992
(973) 799-0994
Mailing address
370 W MARKET ST, NEWARK, NJ 07107-3040
(973) 799-0992
(973) 799-0992
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
332BC3200X
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0021121
—
NJ
01
—
199396
DME
NJ
01
—
41684
DME
NJ
Enumeration date
12/14/2006
Last updated
08/22/2020
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