Healthcare Provider Details

I. General information

NPI: 1922135565
Provider Name (Legal Business Name): RAINBOW SUPPLY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 AVENUE U
BROOKLYN NY
11223-5019
US

IV. Provider business mailing address

1111 AVENUE U
BROOKLYN NY
11223-5019
US

V. Phone/Fax

Practice location:
  • Phone: 718-375-5875
  • Fax: 646-213-3210
Mailing address:
  • Phone: 718-375-5875
  • Fax: 646-213-3210

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
# 3
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: GELENA GOTTO
Title or Position: PRESIDENT
Credential:
Phone: 718-375-5875