Provider Demographics
NPI:1972837193
Name:EMMANUEL MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:EMMANUEL MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GAIRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SNAGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-230-1200
Mailing Address - Street 1:185 PUTNAM AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-1607
Mailing Address - Country:US
Mailing Address - Phone:718-230-1200
Mailing Address - Fax:718-230-1212
Practice Address - Street 1:185 PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11216-1607
Practice Address - Country:US
Practice Address - Phone:718-230-1200
Practice Address - Fax:718-230-1212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies