MEDICARE: DURABLE HEALTH MEDICAL SUPPLY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	332BC3200X	Customized Equipment (DME)
2	332BD1200X	Dialysis Equipment & Supplies (DME)
3	332BN1400X	Nursing Facility Supplies (DME)
4	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
5	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1033737093
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DURABLE HEALTH MEDICAL SUPPLY LLC

Provider Business Mailing Address
First Line	:	5808 FORT HAMILTON PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4832
Country	:	US
Telephone Number	:	516-605-5084
Fax Number	:

Provider Business Practice Location Address
First Line	:	5808 FORT HAMILTON PKWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219-4832
Country	:	US
Telephone Number	:	516-605-5084
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. HENRY K LEE
Credential	:
Telephone Number	:	917-423-8539

Provider Enumeration Date	:	07/07/2020
Last Update Date	:	03/24/2025

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