MEDICARE: PROLAB MEDICAL SUPPLIES 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

General Provider Information

NPI Number	:	1881532265
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROLAB MEDICAL SUPPLIES INC

Provider Business Mailing Address
First Line	:	1001 S MAIN ST STE 500
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-1498
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 S MAIN ST STE 500
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-1498
Country	:	US
Telephone Number	:	848-384-3143
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	IQBAL HUSSAIN
Credential	:
Telephone Number	:	848-384-3143

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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