Provider Demographics
NPI:1205323227
Name:PERFECT FIT MEDICAL SUPPLY
Entity type:Organization
Organization Name:PERFECT FIT MEDICAL SUPPLY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:TYAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-800-8800
Mailing Address - Street 1:1045 ROUTE 70
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:08759-5806
Mailing Address - Country:US
Mailing Address - Phone:732-996-0665
Mailing Address - Fax:732-941-4307
Practice Address - Street 1:1045 ROUTE 70
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NJ
Practice Address - Zip Code:08759
Practice Address - Country:US
Practice Address - Phone:732-996-0665
Practice Address - Fax:732-941-4307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-16
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies