Provider Demographics
NPI:1720011000
Name:MILLENIUM MEDICAL SUPPLIES,INC.
Entity Type:Organization
Organization Name:MILLENIUM MEDICAL SUPPLIES,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAJDI
Authorized Official - Middle Name:
Authorized Official - Last Name:AHEMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-279-1400
Mailing Address - Street 1:5 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2647
Mailing Address - Country:US
Mailing Address - Phone:973-279-1400
Mailing Address - Fax:
Practice Address - Street 1:5 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2647
Practice Address - Country:US
Practice Address - Phone:973-279-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5002656332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7803702Medicaid
NJ1249390001Medicare ID - Type UnspecifiedDURABLE MEDICAL EQUIPMEN