Healthcare Provider Details

I. General information

NPI: 1497701833
Provider Name (Legal Business Name): 01 A LL-STATES MEDICAL SUPPLY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 10/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 OLD HENDERSONVILLE RD SUITE A
FLETCHER NC
28732-9679
US

IV. Provider business mailing address

221 OLD HENDERSONVILLE RD SUITE A
FLETCHER NC
28732-9679
US

V. Phone/Fax

Practice location:
  • Phone: 828-651-8055
  • Fax: 828-651-8297
Mailing address:
  • Phone: 828-651-8055
  • Fax: 828-651-8297

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: MR. MARCUS A SUESS
Title or Position: PRESIDENT
Credential: LPED
Phone: 828-651-8055