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General NPI Number Information
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NPI Number | 1710253414
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Entity Type | Organization
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Legal Business Name | METROCARE MEDICAL SUPPLY
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 06/24/2020
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Provider Practice Location Address
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Address Line | 11033 SUTPHIN BLVD APT 1
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City | JAMAICA
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State | NY
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Zip | 11435-5757
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Country | US
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Telephone | 718-374-3266
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Fax | 718-374-3276
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Provider Business Mailing Address
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Address Line | 16117 N CONDUIT AVE SUITE1
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City | JAMAICA
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State | NY
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Zip | 11434-4436
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Country | US
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Telephone | 718-374-3266
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Fax | 718-374-3276
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JEREMIAH IKECHUKWU IGBOEKWE
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Credential |
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Telephone | 718-374-3266
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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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