Provider Demographics
NPI:1609107283
Name:E & K MEDICAL SUPPLY LLC.
Entity Type:Organization
Organization Name:E & K MEDICAL SUPPLY LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:862-368-0338
Mailing Address - Street 1:256 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:EAST NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07029-2780
Mailing Address - Country:US
Mailing Address - Phone:973-900-9802
Mailing Address - Fax:973-900-9812
Practice Address - Street 1:256 GRANT AVE
Practice Address - Street 2:
Practice Address - City:EAST NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07029-2780
Practice Address - Country:US
Practice Address - Phone:973-900-9802
Practice Address - Fax:973-900-9812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-21
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ43ZA00487300332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies