MEDICARE: MEDCODE

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	:	1396300661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDCODE

Provider Business Mailing Address
First Line	:	2117 CANARSIE RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-5419
Country	:	US
Telephone Number	:	917-407-3446
Fax Number	:

Provider Business Practice Location Address
First Line	:	2117 CANARSIE RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-5419
Country	:	US
Telephone Number	:	917-407-3446
Fax Number	:

Authorized Official
Title or Position	:	MRG
Name	:	SHIRLEY FRANCOIS
Credential	:
Telephone Number	:	917-407-3446

Provider Enumeration Date	:	05/02/2019
Last Update Date	:	05/02/2019

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