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General NPI Number Information
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NPI Number | 1992876171
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Entity Type | Organization
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Legal Business Name | CENTURY MEDICAL SUPPLY LLC
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Dates
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Enumeration Date | 11/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6032 S HALSTED ST #104
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City | CHICAGO
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State | IL
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Zip | 60621-2112
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Country | US
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Telephone | 773-723-6695
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Fax | 773-723-6694
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Provider Business Mailing Address
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Address Line | 6032 S HALSTED ST #104
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City | CHICAGO
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State | IL
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Zip | 60621-2112
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Country | US
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Telephone | 773-723-6695
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Fax | 773-723-6694
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Authorized Official
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Title or Position | OWNER AND MANAGER
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Name | MS. DUOYOU L LIU
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Credential |
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Telephone | 312-498-7683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | IL
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