Healthcare Provider Details

I. General information

NPI: 1538096698
Provider Name (Legal Business Name): AZA SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 N 2ND ST STE 100
RICHMOND KY
40475-1408
US

IV. Provider business mailing address

212 N 2ND ST STE 100
RICHMOND KY
40475-1408
US

V. Phone/Fax

Practice location:
  • Phone: 320-577-7824
  • Fax:
Mailing address:
  • Phone: 320-577-7824
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SAIKUMAR PULIMAMIDI
Title or Position: CEO
Credential: MR
Phone: 320-577-7824