Provider Demographics
NPI:1386011278
Name:ST. REGIS MEDICAL EQUIPMENT CORP.
Entity Type:Organization
Organization Name:ST. REGIS MEDICAL EQUIPMENT CORP.
Other - Org Name:UTICA MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIGLIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-732-7040
Mailing Address - Street 1:233 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13501-2211
Mailing Address - Country:US
Mailing Address - Phone:315-732-7040
Mailing Address - Fax:315-797-2854
Practice Address - Street 1:8195 SENECA TPKE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NY
Practice Address - Zip Code:13323-1100
Practice Address - Country:US
Practice Address - Phone:315-732-7040
Practice Address - Fax:315-797-2854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-26
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0579410002Medicare NSC