Healthcare Provider Details

I. General information

NPI: 1093025074
Provider Name (Legal Business Name): MEDICARE SUPPLIES PLUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 10/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 WALLABOUT ST
BROOKLYN NY
11206-4325
US

IV. Provider business mailing address

291 WALLABOUT ST
BROOKLYN NY
11206-4325
US

V. Phone/Fax

Practice location:
  • Phone: 516-295-2092
  • Fax:
Mailing address:
  • Phone:
  • 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 Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: JUDAH DAVID WEINBERG
Title or Position: PRESIDENT/OWNDER
Credential:
Phone: 516-295-2092