MEDICARE: THE DETAIL DISTRICT 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	:	1275488546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE DETAIL DISTRICT LLC

Provider Business Mailing Address
First Line	:	9311 AVENUE A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-1111
Country	:	US
Telephone Number	:	516-806-8734
Fax Number	:

Provider Business Practice Location Address
First Line	:	9311 AVENUE A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-1111
Country	:	US
Telephone Number	:	517-806-8734
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	KAYLA HENRY
Credential	:
Telephone Number	:	347-756-9939

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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Directions to “THE DETAIL DISTRICT LLC ” Practice Location

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