Healthcare Provider Details

I. General information

NPI: 1326327040
Provider Name (Legal Business Name): US MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2011
Last Update Date: 04/23/2020
Certification Date: 04/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 SMUGGLERS COVE
MACECDON NY
14502
US

IV. Provider business mailing address

PO BOX 376
PENFIELD NY
14526-0376
US

V. Phone/Fax

Practice location:
  • Phone: 585-760-4512
  • Fax: 585-544-3884
Mailing address:
  • Phone: 585-760-4512
  • Fax: 315-538-8099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number008930-1
License Number StateNY

VIII. Authorized Official

Name: DR. ROBERT WARD III
Title or Position: OWNER
Credential:
Phone: 585-760-4512