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General NPI Number Information
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NPI Number | 1356693162
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Entity Type | Organization
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Legal Business Name | INSURED MEDICAL SUPPLY INC.
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Dates
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Enumeration Date | 10/04/2012
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Last Update Date | 04/16/2015
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Provider Practice Location Address
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Address Line | 3340 LONG BEACH RD
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City | OCEANSIDE
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State | NY
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Zip | 11572-5049
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Country | US
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Telephone | 347-400-5373
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Fax |
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Provider Business Mailing Address
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Address Line | 3340 LONG BEACH RD
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City | OCEANSIDE
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State | NY
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Zip | 11572-5049
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Country | US
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Telephone | 347-400-5373
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Fax |
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | LOUIS I NWOKEOCHA
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Credential | M.D
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Telephone | 347-400-5373
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 332BD1200X
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Taxonomy Name | Dialysis Equipment & Supplies (DME)
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License Number |
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 332BN1400X
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Taxonomy Name | Nursing Facility Supplies (DME)
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License Number |
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | NY
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