Healthcare Provider Details

I. General information

NPI: 1588670921
Provider Name (Legal Business Name): ALL PRO MEDICAL SUPPLIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 OLD COUNTRY RD STE 101
PLAINVIEW NY
11803-4938
US

IV. Provider business mailing address

651 OLD COUNTRY RD STE 101
PLAINVIEW NY
11803-4938
US

V. Phone/Fax

Practice location:
  • Phone: 516-495-7777
  • Fax: 516-495-7780
Mailing address:
  • Phone: 516-495-7777
  • Fax: 516-495-7780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 2
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:

# 1
Identifier02531840
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: LEONARD GREG BUTLER
Title or Position: VICE PRESIDENT
Credential:
Phone: 516-495-7777