Provider Demographics
NPI:1215827183
Name:MEDI EASE SUPPLIES LLC
Entity type:Organization
Organization Name:MEDI EASE SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALTAGRACIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-213-6894
Mailing Address - Street 1:560 HUDSON ST STE 301
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-6655
Mailing Address - Country:US
Mailing Address - Phone:201-641-2125
Mailing Address - Fax:201-641-2125
Practice Address - Street 1:299 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704
Practice Address - Country:US
Practice Address - Phone:347-213-6894
Practice Address - Fax:212-888-6024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment