Provider Demographics
NPI:1114980281
Name:NASSAU HEALTH CARE SUPPLIES INC
Entity Type:Organization
Organization Name:NASSAU HEALTH CARE SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:KURLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-377-3851
Mailing Address - Street 1:1849 DARTMOUTH PL
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-4210
Mailing Address - Country:US
Mailing Address - Phone:516-377-3851
Mailing Address - Fax:516-377-3851
Practice Address - Street 1:4574 THIRD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458
Practice Address - Country:US
Practice Address - Phone:718-933-8527
Practice Address - Fax:718-933-8529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01561820Medicaid
0974610001Medicare ID - Type Unspecified