Provider Demographics
NPI:1720231517
Name:MEDEQUIP SUPPLY CORPORATION
Entity Type:Organization
Organization Name:MEDEQUIP SUPPLY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:VINCENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-477-6523
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548-0217
Mailing Address - Country:US
Mailing Address - Phone:516-477-6523
Mailing Address - Fax:516-484-1982
Practice Address - Street 1:5 MARY LN
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1127
Practice Address - Country:US
Practice Address - Phone:516-477-6523
Practice Address - Fax:516-484-1982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies