Provider Demographics
NPI:1316622830
Name:MEDICAL SUPPLIES NEAR ME LLC
Entity type:Organization
Organization Name:MEDICAL SUPPLIES NEAR ME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAFAILOVA
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LD, CDN
Authorized Official - Phone:917-498-4211
Mailing Address - Street 1:1 W END AVE APT 36A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-8293
Mailing Address - Country:US
Mailing Address - Phone:917-498-4211
Mailing Address - Fax:718-676-5589
Practice Address - Street 1:1117 BRIGHTON BEACH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5999
Practice Address - Country:US
Practice Address - Phone:917-498-4211
Practice Address - Fax:718-676-5589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BD1200XSuppliersDurable Medical Equipment & Medical SuppliesDialysis Equipment & Supplies
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No332H00000XSuppliersEyewear Supplier
No332S00000XSuppliersHearing Aid Equipment
No335E00000XSuppliersProsthetic/Orthotic Supplier
No335G00000XSuppliersMedical Foods Supplier
No335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier