MEDICARE: MED-SURG DURABLES 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
1	332BC3200X	Customized Equipment (DME)

General Provider Information

NPI Number	:	1821498973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MED-SURG DURABLES LLC

Provider Business Mailing Address
First Line	:	85 HARRISTOWN RD
Second Line	:
City	:	GLEN ROCK
State	:	NJ
Zip	:	07452-3307
Country	:	US
Telephone Number	:	201-834-1100
Fax Number	:	201-444-2327

Provider Business Practice Location Address
First Line	:	85 HARRISTOWN RD
Second Line	:
City	:	GLEN ROCK
State	:	NJ
Zip	:	07452-3307
Country	:	US
Telephone Number	:	201-834-1100
Fax Number	:	201-444-2327

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	JOHN H HAJJAR
Credential	:	MD
Telephone Number	:	201-834-1100

Provider Enumeration Date	:	08/26/2014
Last Update Date	:	08/26/2014

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