Provider Demographics
NPI:1215173174
Name:QUEST MEDICAL SUPPLIES CORP
Entity type:Organization
Organization Name:QUEST MEDICAL SUPPLIES CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:YURY
Authorized Official - Middle Name:
Authorized Official - Last Name:VAYSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:917-514-4760
Mailing Address - Street 1:363 E.WESTFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ROSELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07204-2320
Mailing Address - Country:US
Mailing Address - Phone:908-241-6969
Mailing Address - Fax:908-241-1612
Practice Address - Street 1:363 E WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07204-2320
Practice Address - Country:US
Practice Address - Phone:908-241-6969
Practice Address - Fax:908-241-1612
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-25
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6318410001Medicare NSC