MEDICARE: B & S MEDICAL SUPPLY INC

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	332BC3200X	Customized Equipment (DME)
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)
3	332B00000X	Durable Medical Equipment & Medical Supplies	1085169	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508347824
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	B & S MEDICAL SUPPLY INC

Provider Business Mailing Address
First Line	:	2962 AVENUE X
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-1808
Country	:	US
Telephone Number	:	718-336-9240
Fax Number	:

Provider Business Practice Location Address
First Line	:	2962 AVENUE X
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-1808
Country	:	US
Telephone Number	:	718-336-9240
Fax Number	:	718-336-9218

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BORIS SIMON
Credential	:
Telephone Number	:	718-336-9240

Provider Enumeration Date	:	08/24/2018
Last Update Date	:	08/24/2018

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Directions to “B & S MEDICAL SUPPLY INC ” Practice Location

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