MEDICARE: MCGUIRE MEDICAL SUPPLY CORPORATIO

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	:	1669786034
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCGUIRE MEDICAL SUPPLY CORPORATIO

Provider Business Mailing Address
First Line	:	8900 S. STONY ISLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617
Country	:	US
Telephone Number	:	773-721-1300
Fax Number	:	773-634-8266

Provider Business Practice Location Address
First Line	:	8900 S. STONY ISLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60617
Country	:	US
Telephone Number	:	773-721-1300
Fax Number	:	773-634-8266

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RICHARD RUDOLPH MCGUIRE
Credential	:
Telephone Number	:	773-721-1300

Provider Enumeration Date	:	07/28/2010
Last Update Date	:	07/28/2010

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