Provider Demographics
NPI:1447388848
Name:MOUNTAINSIDE MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:MOUNTAINSIDE MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZARNOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-797-6482
Mailing Address - Street 1:1642 GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:NY
Mailing Address - Zip Code:13502-5428
Mailing Address - Country:US
Mailing Address - Phone:315-797-6482
Mailing Address - Fax:
Practice Address - Street 1:5995 ROUTE 291
Practice Address - Street 2:
Practice Address - City:MARCY
Practice Address - State:NY
Practice Address - Zip Code:13403
Practice Address - Country:US
Practice Address - Phone:888-687-4334
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4AXB1H400332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies