Provider Demographics
NPI:1194579896
Name:BEETHOVEN MEDICAL SUPPLY INC
Entity type:Organization
Organization Name:BEETHOVEN MEDICAL SUPPLY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GAVRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BINYAMINOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-251-6717
Mailing Address - Street 1:9520 63RD RD FL 2
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1160
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9520 63RD RD FL 2
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1160
Practice Address - Country:US
Practice Address - Phone:347-251-6717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies