Healthcare Provider Details

I. General information

NPI: 1871854463
Provider Name (Legal Business Name): ALL PRO MEDICAL SUPPLIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 05/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 MERRICK RD STE 108
LYNBROOK NY
11563-2400
US

IV. Provider business mailing address

464 E MAIN ST
PATCHOGUE NY
11772-3106
US

V. Phone/Fax

Practice location:
  • Phone: 516-341-7100
  • Fax: 516-341-7293
Mailing address:
  • Phone: 631-475-9000
  • Fax: 631-475-9014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number332B00000X
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number335E00000X
License Number State

VIII. Authorized Official

Name: TIM MOLLENHAUER
Title or Position: CEO
Credential:
Phone: 631-475-9000