Provider Demographics
NPI:1396186771
Name:EMPIRE VENTURES
Entity Type:Organization
Organization Name:EMPIRE VENTURES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAFIU
Authorized Official - Middle Name:ADEWUNMI
Authorized Official - Last Name:ADETAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-589-9561
Mailing Address - Street 1:12, MARSHALL STREET,
Mailing Address - Street 2:APT. 5T
Mailing Address - City:IRVINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07111
Mailing Address - Country:US
Mailing Address - Phone:347-589-9561
Mailing Address - Fax:
Practice Address - Street 1:12, MARSHALL STREET,
Practice Address - Street 2:APT. 5T
Practice Address - City:IRVINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07111
Practice Address - Country:US
Practice Address - Phone:347-589-9561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies