Healthcare Provider Details

I. General information

NPI: 1225023625
Provider Name (Legal Business Name): B&S MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2109 W 5TH ST
BROOKLYN NY
11223-3818
US

IV. Provider business mailing address

2109 W 5TH ST
BROOKLYN NY
11223-3818
US

V. Phone/Fax

Practice location:
  • Phone: 718-336-9240
  • Fax: 718-336-9218
Mailing address:
  • Phone: 718-336-9240
  • Fax: 718-336-9218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number4287900001 FED
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number02205407
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number2575
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number4399513
License Number StateNY

VIII. Authorized Official

Name: BORIS SIMON
Title or Position: PRESIDENT
Credential:
Phone: 718-336-9240