Healthcare Provider Details

I. General information

NPI: 1578862439
Provider Name (Legal Business Name): LAXMI DME INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2011
Last Update Date: 03/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 SPRINGFIELD AVE, SUITE B202
MAPLEWOOD NJ
07040-3437
US

IV. Provider business mailing address

2010 SPRINGFIELD AVE, SUITE B202
MAPLEWOOD NJ
07040-3437
US

V. Phone/Fax

Practice location:
  • Phone: 973-968-6000
  • Fax:
Mailing address:
  • Phone: 973-968-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: RANI DEWAN
Title or Position: OWNER
Credential: CEO
Phone: 973-968-6000