Provider Demographics
NPI:1457826331
Name:NU LIFE MEDICAL SUPPLY
Entity Type:Organization
Organization Name:NU LIFE MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-228-7905
Mailing Address - Street 1:1 ROSSMOOR DR STE 140
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-1596
Mailing Address - Country:US
Mailing Address - Phone:866-416-8543
Mailing Address - Fax:
Practice Address - Street 1:1 ROSSMOOR DR STE 140
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-1596
Practice Address - Country:US
Practice Address - Phone:866-416-8543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-08
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies