Organization
CENTURY MEDICAL SUPPLY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DUOYOU L LIU (OWNER AND MANAGER)
(312) 498-7683
Entity
Organization
Contact information
Practice address
6032 S HALSTED ST, #104, CHICAGO, IL 60621-2112
(773) 723-6695
(773) 723-6694
Mailing address
6032 S HALSTED ST, #104, CHICAGO, IL 60621-2112
(773) 723-6695
(773) 723-6694
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001635718
BCBS OF IL
IL
Enumeration date
11/10/2006
Last updated
08/22/2020
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