MEDICARE: MNF SUPPLIES

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

General Provider Information

NPI Number	:	1538498613
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MNF SUPPLIES

Provider Business Mailing Address
First Line	:	2451 W MOFFAT ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-4310
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2451 W MOFFAT ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-4310
Country	:	US
Telephone Number	:	312-593-2229
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSHUA BERLIANT
Credential	:
Telephone Number	:	312-593-2229

Provider Enumeration Date	:	12/18/2009
Last Update Date	:	12/18/2009

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Directions to “MNF SUPPLIES ” Practice Location

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