Provider Demographics
NPI:1336807304
Name:POSITIVE MED SUPPLIES INC
Entity Type:Organization
Organization Name:POSITIVE MED SUPPLIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:FRAEKHO
Authorized Official - Middle Name:FRAEKHO
Authorized Official - Last Name:DZHURAYEVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-837-6668
Mailing Address - Street 1:9717 101ST AVE
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11416-2523
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9717 101ST AVE
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11416-2523
Practice Address - Country:US
Practice Address - Phone:718-837-6668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies