1487729620 NPI number — A-1 SURGICAL AND MEDICAL SUPPLIES INC

Table of content: (NPI 1487729620)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487729620 NPI number — A-1 SURGICAL AND MEDICAL SUPPLIES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A-1 SURGICAL AND MEDICAL SUPPLIES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487729620
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30 EAST JEFFERSON AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINEOLA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11501-3123
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-741-1087
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 EAST JEFFERSON AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MINEOLA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11501-3123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-741-1087
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CORSENTINO
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
P
Authorized Official Title or Position:
PRESIDENT OWNER
Authorized Official Telephone Number:
516-741-1087

Provider Taxonomy Codes

  • Taxonomy code: 222Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: AZ00236 . This is a "MDNY" identifier . This identifiers is of the category "OTHER".
  • Identifier: G71561 . This is a "EMPIRE BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: G71572 . This is a "EMPIRE BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 040401000676 . This is a "FIDELIS CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: G71571 . This is a "EMPIRE BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00923693 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: G71521 . This is a "EMPIRE BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: G71562 . This is a "EMPIRE BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1000017730 . This is a "AFFINITY HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 544385 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4881406 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: G71573 . This is a "EMPIRE BCBS" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com