Provider Demographics
NPI:1437922614
Name:MTS MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:MTS MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:IZRAILOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-408-0070
Mailing Address - Street 1:1109 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1003
Mailing Address - Country:US
Mailing Address - Phone:718-375-0242
Mailing Address - Fax:718-375-0323
Practice Address - Street 1:1109 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1003
Practice Address - Country:US
Practice Address - Phone:718-375-0242
Practice Address - Fax:718-375-0323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies