Provider Demographics
NPI:1801846100
Name:CK MEDICAL SUPPLY
Entity Type:Organization
Organization Name:CK MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:ALICASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-433-4894
Mailing Address - Street 1:PO BOX 3
Mailing Address - Street 2:
Mailing Address - City:OLD BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11804-0003
Mailing Address - Country:US
Mailing Address - Phone:516-433-4894
Mailing Address - Fax:516-433-4894
Practice Address - Street 1:108 PARKVIEW ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-3428
Practice Address - Country:US
Practice Address - Phone:516-433-4894
Practice Address - Fax:516-433-4894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies