Organization
MID-CENTRAL MEDICAL INC
Active
Other names
American Medical Supply and Service Co.
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAREN MARIE BURTLE (PRESIDENT)
(217) 965-3734
Entity
Organization
Contact information
Practice address
281 E JACKSON ST, VIRDEN, IL 62690-1451
(217) 965-3734
(217) 965-3371
Mailing address
281 E JACKSON ST, VIRDEN, IL 62690-1451
(217) 965-3734
(217) 965-3371
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203.000130
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1696366
—
LA
05
—
200334860A
—
KS
05
—
4581903
—
TN
05
—
626170807
—
MO
05
—
90212333
—
KY
Enumeration date
05/10/2006
Last updated
04/25/2012
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