MEDICARE: AIRLINE DRUG INC.

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	283154	OTHER	MA	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	20058	OTHER	MA	HEALTH NET PLAN

General Provider Information

NPI Number	:	1629072665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AIRLINE DRUG INC.

Provider Business Mailing Address
First Line	:	309 EAST STREET
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01104-2259
Country	:	US
Telephone Number	:	413-737-7456
Fax Number	:	413-737-3814

Provider Business Practice Location Address
First Line	:	309 EAST ST
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01104-2259
Country	:	US
Telephone Number	:	413-737-7456
Fax Number	:	413-781-0642

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CLARK E MATTHEWS JR.
Credential	:
Telephone Number	:	413-737-7456

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	07/27/2012

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Directions to “AIRLINE DRUG INC. ” Practice Location

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