MEDICARE: AMERASIAN MEDICAL SUPPLY CO. INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	15672	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225061641
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERASIAN MEDICAL SUPPLY CO. INC.

Provider Business Mailing Address
First Line	:	1668 ALUM ROCK AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95116-2437
Country	:	US
Telephone Number	:	408-937-0166
Fax Number	:	408-937-0186

Provider Business Practice Location Address
First Line	:	1668 ALUM ROCK AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95116-2437
Country	:	US
Telephone Number	:	408-937-0166
Fax Number	:	408-937-0186

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ZENAIDA NEGROSA BAILON
Credential	:	RN
Telephone Number	:	408-937-0166

Provider Enumeration Date	:	07/09/2006
Last Update Date	:	08/22/2020

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