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General NPI Number Information
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NPI Number | 1487317517
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Entity Type | Organization
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Legal Business Name | PLESSEN MEDICAL SUPPLIES, LLC
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Dates
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Enumeration Date | 10/15/2021
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Last Update Date | 06/01/2022
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Provider Practice Location Address
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Address Line | 3004 ORANGE GROVE, SUITE 2
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City | CHRISTIANSTED
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State | VI
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Zip | 00820
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Country | US
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Telephone | 340-715-7720
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Fax | 340-713-9002
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Provider Business Mailing Address
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Address Line | 3004 ORANGE GROVE, SUITE 2
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City | CHRISTIANSTED
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State | VI
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Zip | 00820
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Country | US
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Telephone | 340-715-7720
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Fax | 340-713-9002
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Authorized Official
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Title or Position | OWNER
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Name | JAN BIJAN TAWAKOL
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Credential | MD
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Telephone | 340-715-7720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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