Provider Demographics
NPI:1336393404
Name:PESH MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:PESH MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MALAMUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-424-1808
Mailing Address - Street 1:4 GREAT MEADOW LANE
Mailing Address - Street 2:SUITE 4-B
Mailing Address - City:EAST HANOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07936
Mailing Address - Country:US
Mailing Address - Phone:973-585-6262
Mailing Address - Fax:973-585-6261
Practice Address - Street 1:4 GREAT MEADOW LANE
Practice Address - Street 2:SUITE 4-B
Practice Address - City:EAST HANOVER
Practice Address - State:NJ
Practice Address - Zip Code:07936
Practice Address - Country:US
Practice Address - Phone:973-585-6262
Practice Address - Fax:973-585-6261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-15
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6447260001Medicare NSC