Provider Demographics
NPI:1821129628
Name:NORTHEAST HOME MEDICAL SUPPLIES INC.
Entity Type:Organization
Organization Name:NORTHEAST HOME MEDICAL SUPPLIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:VINELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-622-8108
Mailing Address - Street 1:15 N LINCOLN DR
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:NY
Mailing Address - Zip Code:12413-2606
Mailing Address - Country:US
Mailing Address - Phone:518-622-8108
Mailing Address - Fax:518-966-4813
Practice Address - Street 1:15 N LINCOLN DR
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:NY
Practice Address - Zip Code:12413-2606
Practice Address - Country:US
Practice Address - Phone:518-622-8108
Practice Address - Fax:518-966-4813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02941115Medicaid
NY6011590001Medicare NSC