Healthcare Provider Details

I. General information

NPI: 1508347824
Provider Name (Legal Business Name): B & S MEDICAL SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 08/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2962 AVENUE X
BROOKLYN NY
11235-1808
US

IV. Provider business mailing address

2962 AVENUE X
BROOKLYN NY
11235-1808
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number1085169
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

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