Provider Demographics
NPI:1659141836
Name:PINEAPPLE MEDICAL SUPPLY INC
Entity Type:Organization
Organization Name:PINEAPPLE MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISHNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIDWANI
Authorized Official - Suffix:
Authorized Official - Credentials:COF,CDME
Authorized Official - Phone:844-204-0286
Mailing Address - Street 1:45 DAN RD STE 125
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-2852
Mailing Address - Country:US
Mailing Address - Phone:844-204-0286
Mailing Address - Fax:781-828-8555
Practice Address - Street 1:45 DAN RD STE 125
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-2852
Practice Address - Country:US
Practice Address - Phone:844-204-0286
Practice Address - Fax:781-828-8555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies