Provider Demographics
NPI:1356962021
Name:EXCELLENT MEDICAL AND SCHOOL SUPPLIES LLC
Entity type:Organization
Organization Name:EXCELLENT MEDICAL AND SCHOOL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOYA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-200-8341
Mailing Address - Street 1:616 E LANDIS AVE STE B1
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-8033
Mailing Address - Country:US
Mailing Address - Phone:856-200-8341
Mailing Address - Fax:
Practice Address - Street 1:17 W LANDIS AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-8122
Practice Address - Country:US
Practice Address - Phone:856-200-8341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies