Provider Demographics
NPI:1831376458
Name:SMG MEDIQUIP, LLC
Entity type:Organization
Organization Name:SMG MEDIQUIP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BART
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-404-4549
Mailing Address - Street 1:18 N PERSHING AVE
Mailing Address - Street 2:
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-3610
Mailing Address - Country:US
Mailing Address - Phone:516-404-4549
Mailing Address - Fax:866-835-7474
Practice Address - Street 1:4792 HEMPSTEAD TPKE
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-2030
Practice Address - Country:US
Practice Address - Phone:516-404-4549
Practice Address - Fax:866-835-7474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies