Healthcare Provider Details

I. General information

NPI: 1023340858
Provider Name (Legal Business Name): EMPIRE MEDICAL EQUIPMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2010
Last Update Date: 02/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 SHAMROCK CT
SYOSSET NY
11791-2417
US

IV. Provider business mailing address

PO BOX 1184
SYOSSET NY
11791-0904
US

V. Phone/Fax

Practice location:
  • Phone: 516-220-0257
  • Fax: 516-882-6086
Mailing address:
  • Phone:
  • Fax: 516-882-6086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. BENJAMIN ALYESHMERNI
Title or Position: PRESIDENT
Credential:
Phone: 516-220-0257