Organization
MEDIVANCE SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMRAN KASHIF (AUTHORIZED OFFICIAL)
(469) 915-5044
Entity
Organization
Contact information
Practice address
1021 E LINCOLNWAY STE 9967, CHEYENNE, WY 82001-4851
(469) 915-5044
Mailing address
1021 E LINCOLNWAY STE 9967, CHEYENNE, WY 82001-4851
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
03/06/2026
Last updated
04/02/2026
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