Organization
PROFESSIONAL MEDICAL & SURGICAL SUPPLY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN C FERRY JR. (COO)
(815) 726-6279
Entity
Organization
Contact information
Practice address
1917 GARNET CT, NEW LENOX, IL 60451-1593
(800) 648-5190
(866) 656-6332
Mailing address
1917 GARNET CT, NEW LENOX, IL 60451-1593
(800) 648-5190
(866) 656-6332
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
013081177
—
WI
05
—
03333653
—
NY
01
—
08574/11.1
MEDICAL EQUIPMENT SUPPLIER
MS
05
—
100259906-00
—
NE
05
—
102562380
—
PA
01
—
1043
HME
AL
01
—
104409276
CERTIFICATE OF REGISTRATION SALE & USE
TN
05
—
1235212556
—
GA
05
—
1235212556
—
IA
05
—
1235212556 FOR MO
—
MO
05
—
1235212556 FOR UT
—
UT
01
—
1347042
STATE OF OHIO FOREIGN BUSINESS LICENSE
OH
05
—
146633158A
—
GA
01
—
16-00483
DME
KS
05
—
200714550A
—
KS
05
—
200819870A
—
IN
01
—
203.001039
HME LICENSE
IL
05
—
3143388
—
OH
01
—
3XXXX3409 FOR NY
CERTIFICATE OF AUTHORITY
NY
05
—
41742200
—
WI
01
—
5306003914
WHOLESALER LICENSE
MI
01
—
6000007643
CERTIFICATE OF DEVICE REGISTRATION
PA
01
—
69000595A
HME LICENSE
IN
05
—
7100081800
—
KY
01
—
F01075656
CERTIFICATE OF AUTHORITY
MO
01
—
HME00240
HME
KY
01
—
HME22862
HME
OH
05
—
ME-0156417
—
MI
01
—
MG01323
SUPPLIER OF MEDICAL EQUIPMENT LICENSE
AR
05
—
NPI
—
IA
05
—
NPI FOR MHCP
—
MN
Enumeration date
10/23/2006
Last updated
03/09/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up