Provider Demographics
NPI:1346779782
Name:OFFICIAL BBL PILLOW
Entity Type:Organization
Organization Name:OFFICIAL BBL PILLOW
Other - Org Name:MEDCARE MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GUSTAVO
Authorized Official - Middle Name:
Authorized Official - Last Name:COMERCIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-709-2166
Mailing Address - Street 1:2881 BELLMORE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-4326
Mailing Address - Country:US
Mailing Address - Phone:516-355-5090
Mailing Address - Fax:
Practice Address - Street 1:2881 BELLMORE AVE
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710
Practice Address - Country:US
Practice Address - Phone:516-355-5090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies