Provider Demographics
NPI:1134144181
Name:CONSOLIDATED MEDICAL & SURGICAL SUPPLY CO.,INC.
Entity Type:Organization
Organization Name:CONSOLIDATED MEDICAL & SURGICAL SUPPLY CO.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:CRANA
Authorized Official - Suffix:
Authorized Official - Credentials:ORTHOTIST
Authorized Official - Phone:845-565-5820
Mailing Address - Street 1:145 WINDSOR HWY STE 211
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-6286
Mailing Address - Country:US
Mailing Address - Phone:845-565-5820
Mailing Address - Fax:845-565-4242
Practice Address - Street 1:145 WINDSOR HWY STE 211
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-6286
Practice Address - Country:US
Practice Address - Phone:845-565-5820
Practice Address - Fax:845-565-4242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BX2000X
NY332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG77361OtherEMPIRE B/C B/S
NY44140OtherMVP
NY51736OtherABP
NY00500312Medicaid
NYG77361OtherEMPIRE B/C B/S