Provider Demographics
NPI:1407512023
Name:JNJ WHOLESALE MEDICAL EQUIPMENT LLC
Entity Type:Organization
Organization Name:JNJ WHOLESALE MEDICAL EQUIPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FUZAILOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-662-1061
Mailing Address - Street 1:2722 MILL AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6422
Mailing Address - Country:US
Mailing Address - Phone:347-662-1061
Mailing Address - Fax:
Practice Address - Street 1:2722 MILL AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6422
Practice Address - Country:US
Practice Address - Phone:347-662-1061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies