Provider Demographics
NPI:1083745111
Name:ACORN MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:ACORN MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-439-1453
Mailing Address - Street 1:320 PARK ST
Mailing Address - Street 2:
Mailing Address - City:HAWORTH
Mailing Address - State:NJ
Mailing Address - Zip Code:07641-1146
Mailing Address - Country:US
Mailing Address - Phone:201-439-1453
Mailing Address - Fax:
Practice Address - Street 1:320 PARK ST
Practice Address - Street 2:
Practice Address - City:HAWORTH
Practice Address - State:NJ
Practice Address - Zip Code:07641-1146
Practice Address - Country:US
Practice Address - Phone:201-774-1843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02299714Medicaid
4122310001Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER