MEDICARE: TOUCHDOWN MEDICAL SUPPLY

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	203544	NY

General Provider Information

NPI Number	:	1760894869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOUCHDOWN MEDICAL SUPPLY

Provider Business Mailing Address
First Line	:	1186 SCHENECTADY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-5828
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1186 SCHENECTADY AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-5828
Country	:	US
Telephone Number	:	917-731-8874
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. WAYNE WARREN YEARWOOD
Credential	:
Telephone Number	:	917-731-8874

Provider Enumeration Date	:	05/22/2014
Last Update Date	:	05/22/2014

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Directions to “TOUCHDOWN MEDICAL SUPPLY ” Practice Location

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