Organization
MEDICAL SUPPLY PLUS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JERLA JANE FREEMAN CPA (CEO PRESIDENT)
(219) 949-7587
Entity
Organization
Contact information
Practice address
1982 GRANT STREET, GARY, IN 46404
(219) 949-7587
(219) 949-7860
Mailing address
PO BOX 2000, GARY, IN 46409
(219) 949-7587
(219) 949-7860
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021622129
BCBS OF ILLINOIS
IL
05
—
200293200A
—
IN
05
—
200293200B
—
IN
01
—
48001666A
WHOLESALE DRUG DIS REFER
IN
Enumeration date
06/24/2006
Last updated
10/05/2011
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