MEDICARE: M & M 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	203.001020	IL

General Provider Information

NPI Number	:	1891950960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M & M SUPPLIES, INC.

Provider Business Mailing Address
First Line	:	251 MILWAUKEE AVE
Second Line	:	STE 1013
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-2809
Country	:	US
Telephone Number	:	877-520-9535
Fax Number	:	847-520-9565

Provider Business Practice Location Address
First Line	:	251 MILWAUKEE AVE
Second Line	:	STE 1013
City	:	BUFFALO GROVE
State	:	IL
Zip	:	60089-2809
Country	:	US
Telephone Number	:	877-520-9535
Fax Number	:	847-520-9565

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. BRENDA AGUAYO
Credential	:
Telephone Number	:	877-520-9535

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	11/29/2010

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