Provider Demographics
NPI:1194191486
Name:ABC DME, INC.
Entity Type:Organization
Organization Name:ABC DME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:HYONGMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-828-0883
Mailing Address - Street 1:4025 150TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-6727
Mailing Address - Country:US
Mailing Address - Phone:718-460-1004
Mailing Address - Fax:718-463-1004
Practice Address - Street 1:4025 150TH ST # 2STO
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-4931
Practice Address - Country:US
Practice Address - Phone:718-460-1004
Practice Address - Fax:718-463-1004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-20
Last Update Date:2023-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7491950001Medicare NSC