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NPI Code Detail

MEDICARE: SP ONE SERVICES INC

MEDICARE: SP ONE SERVICES 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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1760960355
Entity Type Code : Organization
Provider Name (Legal Business Name) : SP ONE SERVICES INC
Provider Business Mailing Address
First Line : 6746 80TH ST
Second Line :
City : MIDDLE VILLAGE
State : NY
Zip : 11379-2925
Country : US
Telephone Number : 718-894-2400
Fax Number : 718-872-9660
Provider Business Practice Location Address
First Line : 6746 80TH ST
Second Line :
City : MIDDLE VILLAGE
State : NY
Zip : 11379-2925
Country : US
Telephone Number : 718-894-2400
Fax Number : 718-872-9660
Authorized Official
Title or Position : OWNER
Name : OLEG BORUKHOV
Credential :
Telephone Number : 718-894-2400
Provider Enumeration Date : 08/06/2018
Last Update Date : 08/06/2018

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Directions to “SP ONE SERVICES INC ” Practice Location

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