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NPI Code Detail

MEDICARE: AIRLINE DRUG INC

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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1922526318
Entity Type Code : Organization
Provider Name (Legal Business Name) : AIRLINE DRUG INC
Provider Business Mailing Address
First Line : 309 EAST ST
Second Line :
City : SPRINGFIELD
State : MA
Zip : 01104-2259
Country : US
Telephone Number : 413-737-7456
Fax Number : 413-737-3814
Provider Business Practice Location Address
First Line : 436 N MAIN ST
Second Line :
City : EAST LONGMEADOW
State : MA
Zip : 01028-1850
Country : US
Telephone Number : 413-233-4095
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. CLARK E MATTHEWS JR.
Credential :
Telephone Number : 413-737-7456
Provider Enumeration Date : 09/06/2017
Last Update Date : 09/06/2017

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Directions to “AIRLINE DRUG INC ” Practice Location

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