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NPI Code Detail

MEDICARE: ALLY MEDICAL SUPPLY INC

MEDICARE: ALLY MEDICAL SUPPLY 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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1528693611
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALLY MEDICAL SUPPLY INC
Provider Business Mailing Address
First Line : 5258 COVENTRY LN
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-7152
Country : US
Telephone Number : 312-493-5657
Fax Number : 317-526-5064
Provider Business Practice Location Address
First Line : 9247 N MERIDIAN ST STE 106
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-1879
Country : US
Telephone Number : 312-493-5657
Fax Number : 317-526-5064
Authorized Official
Title or Position : OWNER
Name : MR. FIRAS ABOLGAR
Credential :
Telephone Number : 312-493-5657
Provider Enumeration Date : 03/09/2020
Last Update Date : 03/09/2020

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Directions to “ALLY MEDICAL SUPPLY INC ” Practice Location

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