Healthcare Provider Details

I. General information

NPI: 1295087336
Provider Name (Legal Business Name): NU-LIFE MEDICAL EQUIPMENT AND SUPPLIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2012
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7300 PITTSFORD PALMYRA RD
FAIRPORT NY
14450-8415
US

IV. Provider business mailing address

7300 PITTSFORD PALMYRA ROAD
FAIRPORT NY
14450-9202
US

V. Phone/Fax

Practice location:
  • Phone: 585-672-5105
  • Fax: 180-043-3069
Mailing address:
  • Phone: 585-672-5105
  • Fax: 180-043-3069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SHAMIM MALIK
Title or Position: PRESIDENT
Credential:
Phone: 585-672-5105