Provider Demographics
NPI:1104951375
Name:L K AMPOLEX INC
Entity type:Organization
Organization Name:L K AMPOLEX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JIN
Authorized Official - Middle Name:PING
Authorized Official - Last Name:LIANG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH, SP
Authorized Official - Phone:718-416-1749
Mailing Address - Street 1:6402 FLUSHING AVE
Mailing Address - Street 2:
Mailing Address - City:MASPETH
Mailing Address - State:NY
Mailing Address - Zip Code:11378-2833
Mailing Address - Country:US
Mailing Address - Phone:718-416-1749
Mailing Address - Fax:
Practice Address - Street 1:6402 FLUSHING AVE
Practice Address - Street 2:
Practice Address - City:MASPETH
Practice Address - State:NY
Practice Address - Zip Code:11378-2833
Practice Address - Country:US
Practice Address - Phone:718-416-1749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023687332BC3200X, 333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment