Provider Demographics
NPI:1518333228
Name:HUMANITIES MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:HUMANITIES MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:IDIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-548-7658
Mailing Address - Street 1:100 STEVENS AVENUE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550
Mailing Address - Country:US
Mailing Address - Phone:914-699-3900
Mailing Address - Fax:914-699-3911
Practice Address - Street 1:100 STEVENS AVENUE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550
Practice Address - Country:US
Practice Address - Phone:914-699-3900
Practice Address - Fax:914-699-3911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322B00000X332B00000X
NY4800460332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies