Provider Demographics
NPI:1679008676
Name:BENEFICIAL MEDICAL SUPPLY
Entity Type:Organization
Organization Name:BENEFICIAL MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKSHIYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-580-0660
Mailing Address - Street 1:50 US HIGHWAY 9 STE 108
Mailing Address - Street 2:GROSSO OFFICE PARK
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1558
Mailing Address - Country:US
Mailing Address - Phone:732-580-0660
Mailing Address - Fax:
Practice Address - Street 1:50 US HIGHWAY 9 STE 108
Practice Address - Street 2:GROSSO OFFICE PARK
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1558
Practice Address - Country:US
Practice Address - Phone:732-580-0660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2017-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Single Specialty