Provider Demographics
NPI:1861654188
Name:DOLPHIN MEDICAL SUPPLIES INC
Entity Type:Organization
Organization Name:DOLPHIN MEDICAL SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GUSHIKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-340-6300
Mailing Address - Street 1:50 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07026-3248
Mailing Address - Country:US
Mailing Address - Phone:973-340-6300
Mailing Address - Fax:973-340-6304
Practice Address - Street 1:50 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-3248
Practice Address - Country:US
Practice Address - Phone:973-340-6300
Practice Address - Fax:973-340-6304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNOT APPLICABLE332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6457030001Medicare NSC