MEDICARE: EXCELLENT DME, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	332BC3200X	Customized Equipment (DME)
3	332BD1200X	Dialysis Equipment & Supplies (DME)
4	332BN1400X	Nursing Facility Supplies (DME)
5	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
6	332BX2000X	Oxygen Equipment & Supplies (DME)

General Provider Information

NPI Number	:	1275107534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EXCELLENT DME, INC.

Provider Business Mailing Address
First Line	:	209-11 UNION TURNPIKE
Second Line	:
City	:	HOLLIS HILLS
State	:	NY
Zip	:	11364
Country	:	US
Telephone Number	:	917-451-1303
Fax Number	:

Provider Business Practice Location Address
First Line	:	209-11 UNION TURNPIKE
Second Line	:
City	:	HOLLIS HILLS
State	:	NY
Zip	:	11364
Country	:	US
Telephone Number	:	917-451-1303
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEVEN KALEN
Credential	:
Telephone Number	:	516-767-6001

Provider Enumeration Date	:	05/19/2021
Last Update Date	:	04/04/2023

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