Organization
MB CARE MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EUGENE GILMANOV (PRESIDENT OF MB CARE MEDICAL SUPPLY)
(708) 615-0860
Entity
Organization
Contact information
Practice address
318 W MADISON AVENUE, SUITE 1, MAYWOOD, IL 60153
(708) 615-0860
(708) 615-0876
Mailing address
318 W MADISON AVENUE, SUITE M, MAYWOOD, IL 60153
(708) 615-0860
(708) 615-0876
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203000226
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01620637
BLUE CROSS BS OF ILLINOIS
—
Enumeration date
10/17/2006
Last updated
11/21/2013
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