Healthcare Provider Details

I. General information

NPI: 1518150598
Provider Name (Legal Business Name): GREEN VALLEY MEDICAL EQUIPMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2007
Last Update Date: 08/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 E MAIN ST
BOUND BROOK NJ
08805-2026
US

IV. Provider business mailing address

214 E MAIN ST
BOUND BROOK NJ
08805-2026
US

V. Phone/Fax

Practice location:
  • Phone: 732-469-1909
  • Fax: 908-688-5871
Mailing address:
  • Phone: 732-469-1909
  • Fax: 908-688-5871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332000000X
TaxonomyMilitary/U.S. Coast Guard Pharmacy
License Number28RS00597500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number28RS00597500
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number28RS00597500
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number28RS00597500
License Number StateNJ
# 5
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number28RS00597500
License Number StateNJ

VIII. Authorized Official

Name: MRS. CAROL BELGRAVE
Title or Position: PRESIDENT
Credential:
Phone: 732-469-1909