Provider Demographics
NPI:1710983382
Name:SBL HOME MEDICAL EQUIPMENT INC
Entity Type:Organization
Organization Name:SBL HOME MEDICAL EQUIPMENT INC
Other - Org Name:ALPINE HOME MEDICAL EQUIPMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-941-0777
Mailing Address - Street 1:52 ENTER LN
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-4811
Mailing Address - Country:US
Mailing Address - Phone:631-941-0777
Mailing Address - Fax:631-941-0780
Practice Address - Street 1:52 ENTER LN
Practice Address - Street 2:
Practice Address - City:ISLANDIA
Practice Address - State:NY
Practice Address - Zip Code:11749-4811
Practice Address - Country:US
Practice Address - Phone:631-941-0777
Practice Address - Fax:631-941-0780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01288673Medicaid
NY0236900001Medicare NSC