Provider Demographics
NPI:1235156001
Name:DISTINCT PRODUCTS DISTRIBUTION CENTER LLC
Entity Type:Organization
Organization Name:DISTINCT PRODUCTS DISTRIBUTION CENTER LLC
Other - Org Name:ALL BUDGETS MEDICAL SUPPLY CO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BENAIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:OMIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-297-5978
Mailing Address - Street 1:1315 ROUTE 9
Mailing Address - Street 2:SUITE 109
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-4906
Mailing Address - Country:US
Mailing Address - Phone:845-297-5978
Mailing Address - Fax:845-231-6012
Practice Address - Street 1:1315 ROUTE 9
Practice Address - Street 2:SUITE 109
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4906
Practice Address - Country:US
Practice Address - Phone:845-297-5978
Practice Address - Fax:845-231-6012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherTIN
NY=========OtherTIN