Provider Demographics
NPI:1841400975
Name:ASSURED MEDICAL SUPPLY
Entity Type:Organization
Organization Name:ASSURED MEDICAL SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BOB
Authorized Official - Middle Name:H
Authorized Official - Last Name:OBIORA
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:718-251-2962
Mailing Address - Street 1:654 E 79TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3310
Mailing Address - Country:US
Mailing Address - Phone:718-251-2962
Mailing Address - Fax:718-251-2962
Practice Address - Street 1:654 E 79TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3310
Practice Address - Country:US
Practice Address - Phone:718-251-2962
Practice Address - Fax:718-251-2962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1256390332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies