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General NPI Number Information
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NPI Number | 1831174259
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Entity Type | Organization
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Legal Business Name | HEALTH SUPPORT MEDIC SUPPLY
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Dates
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Enumeration Date | 12/08/2005
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Last Update Date | 03/08/2021
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Provider Practice Location Address
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Address Line | 7608 18TH AVE HEALTH SUPPORT MEDICAL SUPPLY INC
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City | BROOKLYN
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State | NY
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Zip | 11214
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Country | US
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Telephone | 718-621-6090
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Fax | 718-621-6092
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Provider Business Mailing Address
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Address Line | PO BOX 1400003 HEALTH SUPPORT MEDICAL SUPPLY INC
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City | BROOKLYN
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State | NY
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Zip | 11214-0003
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Country | US
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Telephone | 718-621-6090
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Fax | 718-621-6092
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MR. ORKHAN YUSUFOV
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Credential |
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Telephone | 917-478-0410
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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Taxonomy #2
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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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