Provider Demographics
NPI:1922584655
Name:STRAC MEDICAL LLC
Entity Type:Organization
Organization Name:STRAC MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEVRIES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-295-1015
Mailing Address - Street 1:75 WASHINGTON VALLEY RD SUITE 170
Mailing Address - Street 2:
Mailing Address - City:BEDMINSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07921
Mailing Address - Country:US
Mailing Address - Phone:908-295-1015
Mailing Address - Fax:908-345-5097
Practice Address - Street 1:75 WASHINGTON VALLEY RD SUITE 170
Practice Address - Street 2:
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921
Practice Address - Country:US
Practice Address - Phone:908-295-1015
Practice Address - Fax:908-345-5097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1194249250OtherNPI NUMBER