Provider Demographics
NPI:1013591148
Name:WHITEHOUSE MEDICAL EQUIPMENT AND SUPPLIES, LLC
Entity Type:Organization
Organization Name:WHITEHOUSE MEDICAL EQUIPMENT AND SUPPLIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-587-4807
Mailing Address - Street 1:11835 QUEENS BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-7211
Mailing Address - Country:US
Mailing Address - Phone:917-587-4807
Mailing Address - Fax:
Practice Address - Street 1:11835 QUEENS BLVD STE 400
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-7211
Practice Address - Country:US
Practice Address - Phone:917-587-4807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies