Healthcare Provider Details

I. General information

NPI: 1114670221
Provider Name (Legal Business Name): FIRSTCARE MEDICAL SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2022
Last Update Date: 01/28/2022
Certification Date: 01/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 LIBERTY AVE
BROOKLYN NY
11208-2221
US

IV. Provider business mailing address

735 LIBERTY AVE
BROOKLYN NY
11208-2221
US

V. Phone/Fax

Practice location:
  • Phone: 718-235-5500
  • Fax:
Mailing address:
  • Phone: 718-235-5500
  • 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 Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MS. BRIDGETTE MITCHELL
Title or Position: OWNER
Credential:
Phone: 646-345-6291