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Organization

A-1 MEDICAL SUPPLY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BLAISE BENEVENGA (OWNER / MANAGING MEMEBERS)
(201) 891-3000
Entity
Organization

Contact information

Practice address
681 LAWLINS RD, BAY 50 SUITE 104, WYCKOFF, NJ 07481-1449
(201) 891-3000
(201) 891-3001
Mailing address
681 LAWLINS RD, BAY 50 SUITE 104, WYCKOFF, NJ 07481-1449
(201) 891-3000
(201) 891-3001

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
PENDING
NJ

Other

Enumeration date
12/20/2010
Last updated
12/20/2010
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