Organization
ANDERSON MEDICAL SUPPLY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL ANDERSON (PRESIDENT)
(815) 462-1373
Entity
Organization
Contact information
Practice address
17552 LARKSPUR CT, HOMER GLEN, IL 60491-9794
(815) 462-1373
Mailing address
17552 LARKSPUR CT, HOMER GLEN, IL 60491-9794
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1526007
AETNA
TX
05
—
331008609001
—
IL
Enumeration date
03/26/2007
Last updated
01/15/2008
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