Healthcare Provider Details

I. General information

NPI: 1699249730
Provider Name (Legal Business Name): CITY MEDICAL SUPPLIES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2019
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13689 37TH AVE STE 1
FLUSHING NY
11354-4586
US

IV. Provider business mailing address

13689 37TH AVE STE 1
FLUSHING NY
11354-4586
US

V. Phone/Fax

Practice location:
  • Phone: 718-799-0970
  • Fax: 718-799-0972
Mailing address:
  • Phone: 718-799-0970
  • Fax: 718-799-0972

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

VIII. Authorized Official

Name: CHUN HAN CHEN
Title or Position: PRESIDENT
Credential:
Phone: 718-799-0970