Provider Demographics
NPI:1003171232
Name:DURAMED MEDICAL SUPPLIES, LLC
Entity Type:Organization
Organization Name:DURAMED MEDICAL SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRGENTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-667-1865
Mailing Address - Street 1:1030 KINGS HWY N
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1907
Mailing Address - Country:US
Mailing Address - Phone:856-667-1865
Mailing Address - Fax:856-667-1823
Practice Address - Street 1:1030 KINGS HWY N
Practice Address - Street 2:SUITE 200
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1907
Practice Address - Country:US
Practice Address - Phone:856-667-1865
Practice Address - Fax:856-667-1823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies