Provider Demographics
NPI:1710164421
Name:RANBOW SUPPLY OF N.Y., INC.
Entity Type:Organization
Organization Name:RANBOW SUPPLY OF N.Y., INC.
Other - Org Name:RAINBOW SUPPLY OF NY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PINKHAS
Authorized Official - Middle Name:
Authorized Official - Last Name:KALANTAROV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-326-2822
Mailing Address - Street 1:237 BEACH 20TH STREET STORE #7
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-3625
Mailing Address - Country:US
Mailing Address - Phone:718-337-0190
Mailing Address - Fax:718-337-0191
Practice Address - Street 1:237 BEACH 20TH STREET STORE7
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-3625
Practice Address - Country:US
Practice Address - Phone:718-337-0190
Practice Address - Fax:718-337-0191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5549220002Medicare NSC