Provider Demographics
NPI:1164771267
Name:EMPIRE MEDIQUIP LLC
Entity Type:Organization
Organization Name:EMPIRE MEDIQUIP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JACINTO
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-235-6734
Mailing Address - Street 1:35 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008
Mailing Address - Country:US
Mailing Address - Phone:386-235-6734
Mailing Address - Fax:
Practice Address - Street 1:120 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:386-235-6734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies