Provider Demographics
NPI:1639790066
Name:FORTIFY MEDICAL DEVICES & SUPPLIES
Entity Type:Organization
Organization Name:FORTIFY MEDICAL DEVICES & SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-321-0593
Mailing Address - Street 1:74 CEDAR SWAMP RD # 4
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-4376
Mailing Address - Country:US
Mailing Address - Phone:516-321-0593
Mailing Address - Fax:
Practice Address - Street 1:74 CEDAR SWAMP RD # 4
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-4376
Practice Address - Country:US
Practice Address - Phone:516-321-0593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-27
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies