Healthcare Provider Details

I. General information

NPI: 1245840545
Provider Name (Legal Business Name): PHRYGREEN MEDICAL EQUIPMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 08/03/2020
Certification Date: 08/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 DUTCH HILL RD # GL-2
ORANGEBURG NY
10962-1723
US

IV. Provider business mailing address

60 DUTCH HILL RD # GL-2
ORANGEBURG NY
10962-1723
US

V. Phone/Fax

Practice location:
  • Phone: 845-450-1240
  • Fax:
Mailing address:
  • Phone: 845-450-1240
  • 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: MR. JOSEPH FEDER
Title or Position: CEO
Credential:
Phone: 845-450-1240