Provider Demographics
NPI:1679943559
Name:AURORA EQUIPMENT SUPPLY
Entity type:Organization
Organization Name:AURORA EQUIPMENT SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:DELORIS
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-947-0569
Mailing Address - Street 1:11712 DOXDAM TERRACE
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876
Mailing Address - Country:US
Mailing Address - Phone:301-947-0569
Mailing Address - Fax:
Practice Address - Street 1:11712 DOXDAM TERRACE
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20876
Practice Address - Country:US
Practice Address - Phone:301-947-0569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies