=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740176874
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DME MEDICAL LOGISTICS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/16/2025
-----------------------------------------------------
Last Update Date | 06/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 109 FAIRFIELD WAY STE 106E
-----------------------------------------------------
City | BLOOMINGDALE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60108-1522
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-885-0414
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 109 FAIRFIELD WAY STE 106E
-----------------------------------------------------
City | BLOOMINGDALE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60108-1522
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-885-0414
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COO
-----------------------------------------------------
Name | HAASHIM AZAM
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 630-885-0414
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------