Organization
MARS MEDICAL EQUIPMENT & SUPPLY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL J MAROLDA (PRESIDENT)
(708) 425-1550
Entity
Organization
Contact information
Practice address
333 W MAPLE ST, UNIT 2, NEW LENOX, IL 60451-1633
(708) 425-1550
(815) 462-9358
Mailing address
333 W MAPLE ST, UNIT 2, NEW LENOX, IL 60451-1633
(708) 425-1550
(815) 462-9358
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203000219
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21623109
BLUE CROSS NUMBER
IL
Enumeration date
06/21/2005
Last updated
07/16/2008
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