MEDICARE: SAPPHIRE DISTRIBUTION 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1750051546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAPPHIRE DISTRIBUTION LLC

Provider Business Mailing Address
First Line	:	744 N WELLS ST STE 101
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-3521
Country	:	US
Telephone Number	:	312-877-5132
Fax Number	:

Provider Business Practice Location Address
First Line	:	744 N WELLS ST STE 101
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60654-3521
Country	:	US
Telephone Number	:	260-425-0253
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER/CEO
Name	:	MR. SAAD CHOWDHRY
Credential	:
Telephone Number	:	312-877-5132

Provider Enumeration Date	:	09/14/2021
Last Update Date	:	12/17/2021

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