Healthcare Provider Details

I. General information

NPI: 1326978586
Provider Name (Legal Business Name): NOVA MEDIX SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15047 75TH RD APT 1E
FLUSHING NY
11367-2917
US

IV. Provider business mailing address

15047 75TH RD APT 1E
FLUSHING NY
11367-2917
US

V. Phone/Fax

Practice location:
  • Phone: 844-504-7983
  • Fax:
Mailing address:
  • Phone: 844-504-7983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AMJAD KHAN
Title or Position: OWNER
Credential: N/A
Phone: 844-504-7983