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NPI Code Detail

MEDICARE: DME ORTHOSUPPLYSTORE, LLC

MEDICARE: DME ORTHOSUPPLYSTORE, LLC
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1750692331
Entity Type Code : Organization
Provider Name (Legal Business Name) : DME ORTHOSUPPLYSTORE, LLC
Provider Business Mailing Address
First Line : 4913 13TH AVE.
Second Line :
City : BROOKLYN
State : NY
Zip : 11219
Country : US
Telephone Number : 718-431-8702
Fax Number : 888-281-0459
Provider Business Practice Location Address
First Line : 4913 13TH AVE.
Second Line :
City : BROOKLYN
State : NY
Zip : 11219
Country : US
Telephone Number : 718-431-8702
Fax Number : 888-281-0459
Authorized Official
Title or Position : EXECUTIVE
Name : MS. EUDELL HAYES
Credential :
Telephone Number : 718-369-8000
Provider Enumeration Date : 06/29/2010
Last Update Date : 06/16/2011

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Directions to “DME ORTHOSUPPLYSTORE, LLC ” Practice Location

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