MEDICARE: MEDICALSUPPLY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417114984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICALSUPPLY LLC

Provider Business Mailing Address
First Line	:	8023 W NATIONAL AVE
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53214-4507
Country	:	US
Telephone Number	:	414-302-6337
Fax Number	:

Provider Business Practice Location Address
First Line	:	8023 W NATIONAL AVE
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53214-4507
Country	:	US
Telephone Number	:	414-302-6337
Fax Number	:

Authorized Official
Title or Position	:	OFFICER
Name	:	MR. ILYA BEYDER
Credential	:
Telephone Number	:	414-302-6337

Provider Enumeration Date	:	05/21/2008
Last Update Date	:	06/03/2008

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1790873602 — MR. ILYA BEYDER
Practice Location Address:

8023 W NATIONAL AVE
WEST ALLIS, WI
53214-4507

Practice Phone: 414-302-6337
Practice Fax: 414-755-2039

1750893236 — DR. ANJALI SUDERSHAN KRISHAN MEHTA DMD
Practice Location Address:

8001 W NATIONAL AVE
WEST ALLIS, WI
53214-4507

Practice Phone: 414-327-6363
Practice Fax:

1063160521 — WISCONSIN DENTAL GROUP, S.C.
Practice Location Address:

8001 W NATIONAL AVE
WEST ALLIS, WI
53214-4507

Practice Phone: 608-231-2006
Practice Fax:

1265270680 — SEAN SOMCHENE LUANGPRASEUTH DDS
Practice Location Address:

8001 W NATIONAL AVE
WEST ALLIS, WI
53214-4507

Practice Phone: 414-327-6363
Practice Fax:

1285938738 — DANA MARIE DURKIN DPT
Practice Location Address:

893 S MATLACK ST STE 150
WEST CHESTER, PA
19382-4507

Practice Phone: 484-318-8274
Practice Fax: 484-947-0946

Directions to “MEDICALSUPPLY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.