Organization
AGASSIZ HEALTHCARE SUPPLY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE BUCKLEY (OWNER)
(928) 522-0507
Entity
Organization
Contact information
Practice address
2573 E 7TH AVE, FLAGSTAFF, AZ 86004-3722
(928) 522-0507
(928) 522-9324
Mailing address
PO BOX 3208, FLAGSTAFF, AZ 86003-3208
(928) 522-0507
(928) 522-9324
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
03029785
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
455172
—
AZ
Enumeration date
04/17/2006
Last updated
08/22/2020
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