MEDICARE: NATIONWIDE DME SUPPLIES LLC

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	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1295624419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONWIDE DME SUPPLIES LLC

Provider Business Mailing Address
First Line	:	851 FARM DR
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-4948
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	851 FARM DR
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-4948
Country	:	US
Telephone Number	:	307-289-2158
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHAHID ALI
Credential	:
Telephone Number	:	307-289-2158

Provider Enumeration Date	:	07/01/2025
Last Update Date	:	07/01/2025

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