Provida Medical Supply, Inc.

LBN: Provida Medical Supply, Inc.
Provida Medical Supply, Inc. is an health care organization with primary practice located at 1117 S Milwaukee Ave Suite D 5, Libertyville IL 60048-5257. The organization recently has only one registered license in Suppliers / Oxygen Equipment & Supplies, which is considered as the primary health care specialty. Provida Medical Supply, Inc. can be contacted via phone (847) 918-8085, or through Troyak, Luda via phone (847) 918-8085.

Contact Information

Primary practice address
1117 S Milwaukee Ave Suite D 5 Libertyville IL 60048-5257
Phone: (847) 918-8085
Fax: (847) 573-0223
Website:
Map and Directions
Authorized official contact:
Name: Troyak, Luda
Phone: (847) 918-8085

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Oxygen Equipment & Supplies 332BX2000X 203001360 Illinois

Profile Details

NPI number 1023395381
LBN Legal business name Provida Medical Supply, Inc.
DBA Doing business as
Authorized official Troyak, Luda
Entity Organization
Organization subpart 1 No
Enumeration date Nov 14th, 2011
Last updated Apr 5th, 2012 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1023395381 NPPES
Illinois Other 203001360 LICENSE

Popular Providers