Provider Demographics
NPI:1083069546
Name:MEDSTAR SURGICAL & BREATHING EQUIPMENT, INC.
Entity Type:Organization
Organization Name:MEDSTAR SURGICAL & BREATHING EQUIPMENT, INC.
Other - Org Name:LANDAUER MEDSTAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRIGGS
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-206-0040
Mailing Address - Street 1:99 POWERHOUSE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2039
Mailing Address - Country:US
Mailing Address - Phone:484-362-2448
Mailing Address - Fax:
Practice Address - Street 1:122 MILL RD
Practice Address - Street 2:A150
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-1413
Practice Address - Country:US
Practice Address - Phone:484-362-2448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies