Provider Demographics
NPI:1639792906
Name:UNIVERSAL DM SUPPLIES LLC
Entity Type:Organization
Organization Name:UNIVERSAL DM SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NEHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PATHAK
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:614-537-2453
Mailing Address - Street 1:123 W 20TH ST # 1W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-3639
Mailing Address - Country:US
Mailing Address - Phone:646-923-6999
Mailing Address - Fax:
Practice Address - Street 1:123 W 20TH ST # 1W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-3639
Practice Address - Country:US
Practice Address - Phone:646-923-6999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies