Healthcare Provider Details

I. General information

NPI: 1427227560
Provider Name (Legal Business Name): SUPPLY SOLUTIONS A DIVISION OF NORTHEAST MOBILITY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 EVERETT RD
ALBANY NY
12205-1407
US

IV. Provider business mailing address

115 EVERETT RD
ALBANY NY
12205-1407
US

V. Phone/Fax

Practice location:
  • Phone: 518-438-3646
  • Fax: 518-453-0919
Mailing address:
  • Phone: 518-438-3646
  • Fax: 518-453-0919

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNY

VIII. Authorized Official

Name: WILLIAM ECKERT
Title or Position: PRESIDENT
Credential:
Phone: 518-438-3646