Provider Demographics
NPI:1629087606
Name:OSABUOHIEN IROWA
Entity Type:Organization
Organization Name:OSABUOHIEN IROWA
Other - Org Name:DURABLE MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OSABUOHIEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:IROWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-454-4751
Mailing Address - Street 1:134 EVERGREEN PLACE
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018
Mailing Address - Country:US
Mailing Address - Phone:973-672-0707
Mailing Address - Fax:973-672-0701
Practice Address - Street 1:134 EVERGREEN PLACE
Practice Address - Street 2:8TH FLOOR
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018
Practice Address - Country:US
Practice Address - Phone:973-672-0707
Practice Address - Fax:973-672-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-07
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0027154Medicaid
4934480001Medicare NSC