Organization
ABBA MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA WAGNER (PRESIDENT/OWNER)
(603) 778-1698
Entity
Organization
Contact information
Practice address
72 PORTSMOUTH AVE, SUITE 104, STRATHAM, NH 03885-2566
(603) 778-1698
(603) 772-5885
Mailing address
72 PORTSMOUTH AVE, SUITE 104, STRATHAM, NH 03885-2566
(603) 778-1698
(603) 772-5885
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
4224
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020463317
TRICARE
—
01
—
1203280YONHI
BLUE CROSS BLUE SHIELD
NH
01
—
292170
HEALTHSOURCE
—
05
—
30008709
—
NH
01
—
PO020021
CHAMPA AVA
—
Enumeration date
10/11/2005
Last updated
03/03/2012
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