Healthcare Provider Details

I. General information

NPI: 1639746126
Provider Name (Legal Business Name): DEMETRICES MED SUPPLIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

378 E GUN HILL RD
BRONX NY
10467-2202
US

IV. Provider business mailing address

PO BOX 661447
BRONX NY
10466-0242
US

V. Phone/Fax

Practice location:
  • Phone: 914-306-7644
  • Fax:
Mailing address:
  • Phone: 914-306-7644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: ABDULAI M A ADAMS
Title or Position: OWNER
Credential:
Phone: 914-306-7644