Provider Demographics
NPI:1578037602
Name:DURAMED INC
Entity Type:Organization
Organization Name:DURAMED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOFREDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-365-8825
Mailing Address - Street 1:960 S BROADWAY STE 120
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-5028
Mailing Address - Country:US
Mailing Address - Phone:480-365-8825
Mailing Address - Fax:
Practice Address - Street 1:960 S BROADWAY STE 120
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-5028
Practice Address - Country:US
Practice Address - Phone:480-365-8825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CANBIOLA INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies