Provider Demographics
NPI:1598967531
Name:PREFERED MEDICAL & HOME CARE SUPPLY
Entity Type:Organization
Organization Name:PREFERED MEDICAL & HOME CARE SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-230-8800
Mailing Address - Street 1:109 WILSON AVE
Mailing Address - Street 2:STORE FRONT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-2385
Mailing Address - Country:US
Mailing Address - Phone:718-230-8800
Mailing Address - Fax:718-927-0589
Practice Address - Street 1:109 WILSON AVE
Practice Address - Street 2:STORE FRONT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-2385
Practice Address - Country:US
Practice Address - Phone:718-230-8800
Practice Address - Fax:718-927-0589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6010180001Medicare NSC