Provider Demographics
NPI:1639151103
Name:MEDICARE SUPPLIES PLUS INC
Entity Type:Organization
Organization Name:MEDICARE SUPPLIES PLUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JUDAH
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-295-2092
Mailing Address - Street 1:174C MEACHAM AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2632
Mailing Address - Country:US
Mailing Address - Phone:516-295-2092
Mailing Address - Fax:516-295-2178
Practice Address - Street 1:174C MEACHAM AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2632
Practice Address - Country:US
Practice Address - Phone:516-295-2092
Practice Address - Fax:516-295-2178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01371342Medicaid
NY01371342Medicaid
NY0384570001Medicare NSC