Healthcare Provider Details
I. General information
NPI: 1275441537
Provider Name (Legal Business Name): BLUEPEAK MEDICAL SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/28/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4249 COLDEN ST APT 7V
FLUSHING NY
11355-3904
US
IV. Provider business mailing address
8401 MAYLAND DR # 11438
RICHMOND VA
23294-4648
US
V. Phone/Fax
- Phone: 929-444-1882
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
OWAIS
AHMED
Title or Position: CEO
Credential:
Phone: 914-431-5767