Healthcare Provider Details

I. General information

NPI: 1679483622
Provider Name (Legal Business Name): VENTARA EQUIPMENT SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 IVANHOE DR APT B11
MONROEVILLE PA
15146-2641
US

IV. Provider business mailing address

4150 IVANHOE DR APT B11
MONROEVILLE PA
15146-2641
US

V. Phone/Fax

Practice location:
  • Phone: 847-796-1641
  • Fax:
Mailing address:
  • Phone: 847-796-1641
  • Fax: 847-796-1641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. AVINASH GUBBALA
Title or Position: DIRECTOR
Credential:
Phone: 847-796-1641