Provider Demographics
NPI:1447358312
Name:MARTIN BROTHERS DISTRIBUTING
Entity type:Organization
Organization Name:MARTIN BROTHERS DISTRIBUTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT MED SUPPLIES
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:R
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-266-1775
Mailing Address - Street 1:406 VIKING RD
Mailing Address - Street 2:PO BOX 69
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-6930
Mailing Address - Country:US
Mailing Address - Phone:319-266-1775
Mailing Address - Fax:319-266-8947
Practice Address - Street 1:406 VIKING RD
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-6930
Practice Address - Country:US
Practice Address - Phone:319-266-1775
Practice Address - Fax:319-266-8947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies