Provider Demographics
NPI:1801623749
Name:REIDS MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:REIDS MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:TIYANI
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-893-9399
Mailing Address - Street 1:1111 STRATFORD AVE APT 116
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-6365
Mailing Address - Country:US
Mailing Address - Phone:203-893-9399
Mailing Address - Fax:
Practice Address - Street 1:2389 MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4617
Practice Address - Country:US
Practice Address - Phone:203-893-9399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies