Healthcare Provider Details

I. General information

NPI: 1285873281
Provider Name (Legal Business Name): AHC MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 04/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

963 E 6600 S
MURRAY UT
84121-2444
US

IV. Provider business mailing address

5323 MURRAY BLVD
MURRAY UT
84123-6973
US

V. Phone/Fax

Practice location:
  • Phone: 801-713-3154
  • Fax: 888-542-6662
Mailing address:
  • Phone: 801-713-3254
  • Fax: 888-542-6662

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: MARK EMMETT
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 253-670-5700