MEDICARE: WHITE AID MEDICAL SUPPLY 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	332BX2000X	Oxygen Equipment & Supplies (DME)
2	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1093716334
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHITE AID MEDICAL SUPPLY INC

Provider Business Mailing Address
First Line	:	674 MYRTLE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205-3950
Country	:	US
Telephone Number	:	718-852-8222
Fax Number	:	718-232-3243

Provider Business Practice Location Address
First Line	:	674 MYRTLE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205
Country	:	US
Telephone Number	:	718-852-8222
Fax Number	:	718-232-3243

Authorized Official
Title or Position	:	CEO
Name	:	SAMUEL GUTMAN
Credential	:
Telephone Number	:	718-852-8222

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	09/23/2024

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