Healthcare Provider Details

I. General information

NPI: 1912527490
Provider Name (Legal Business Name): DME FAMILY CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10810 72ND AVE FL 3
FOREST HILLS NY
11375-5338
US

IV. Provider business mailing address

10810 72ND AVE FL 3
FOREST HILLS NY
11375-5338
US

V. Phone/Fax

Practice location:
  • Phone: 718-702-4234
  • Fax: 845-618-7082
Mailing address:
  • Phone: 718-702-4234
  • Fax: 845-618-7082

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 Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MINKYUNG AN
Title or Position: PRESIDENT
Credential:
Phone: 718-702-4234