Provider Demographics
NPI:1104014380
Name:NEWERA MEDICAL EQUIPMENT/SUPPLIES
Entity Type:Organization
Organization Name:NEWERA MEDICAL EQUIPMENT/SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:IFEANYI
Authorized Official - Middle Name:GODWIN
Authorized Official - Last Name:OBIORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-366-7500
Mailing Address - Street 1:SUITE 3103 DRUMMOND PLAZA OFFICE PARK
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-5745
Mailing Address - Country:US
Mailing Address - Phone:302-366-7500
Mailing Address - Fax:302-366-7400
Practice Address - Street 1:SUITE 3103 DRUMMOND PLAZA OFFICE PARK
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-5745
Practice Address - Country:US
Practice Address - Phone:302-366-7500
Practice Address - Fax:302-366-7400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2007603652332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE5994390001Medicare NSC