MEDICARE: MEDICARE SUPPLIES PLUS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
2	332BX2000X	Oxygen Equipment & Supplies (DME)
3	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1093025074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICARE SUPPLIES PLUS

Provider Business Mailing Address
First Line	:	291 WALLABOUT ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11206-4325
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	291 WALLABOUT ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11206-4325
Country	:	US
Telephone Number	:	516-295-2092
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNDER
Name	:	JUDAH DAVID WEINBERG
Credential	:
Telephone Number	:	516-295-2092

Provider Enumeration Date	:	10/08/2010
Last Update Date	:	10/08/2010

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