MEDICARE: BREAST PUMPS GENIE LLC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1134719875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BREAST PUMPS GENIE LLC.

Provider Business Mailing Address
First Line	:	3020 NW 27TH ST
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33311-2001
Country	:	US
Telephone Number	:	646-400-4629
Fax Number	:

Provider Business Practice Location Address
First Line	:	1889 BACON ST STE 13
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-3052
Country	:	US
Telephone Number	:	646-400-4629
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DOVID RENDLER
Credential	:
Telephone Number	:	718-666-1870

Provider Enumeration Date	:	01/26/2021
Last Update Date	:	01/26/2021

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Directions to “BREAST PUMPS GENIE LLC. ” Practice Location

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