Provider Demographics
NPI:1033171798
Name:NATIONAL SURGICAL SUPPLY COMPANY
Entity type:Organization
Organization Name:NATIONAL SURGICAL SUPPLY COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:DESMARAIS
Authorized Official - Suffix:
Authorized Official - Credentials:RCP
Authorized Official - Phone:401-783-1850
Mailing Address - Street 1:14 WOODRUFF AVE STE 13
Mailing Address - Street 2:
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-3467
Mailing Address - Country:US
Mailing Address - Phone:401-783-1850
Mailing Address - Fax:
Practice Address - Street 1:14 WOODRUFF AVE STE 13
Practice Address - Street 2:
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-3467
Practice Address - Country:US
Practice Address - Phone:401-783-1850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0874550001Medicare NSC