Healthcare Provider Details

I. General information

NPI: 1124330071
Provider Name (Legal Business Name): EVEREST MEDICAL AND ORTHOPEDIC SUPPLY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2010
Last Update Date: 07/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 OLD COUNTRY RD
PLAINVIEW NY
11803-4904
US

IV. Provider business mailing address

510 OLD COUNTRY RD
PLAINVIEW NY
11803-4904
US

V. Phone/Fax

Practice location:
  • Phone: 516-622-1300
  • Fax: 516-622-1310
Mailing address:
  • Phone: 516-622-1300
  • Fax: 516-622-1310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. CHRISTOPHER ETTS
Title or Position: MANGAING MEMBER
Credential:
Phone: 516-903-8562