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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