Provider Demographics
NPI:1396126926
Name:NATIONALWIDE MEDICAL SUPPLY
Entity type:Organization
Organization Name:NATIONALWIDE MEDICAL SUPPLY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OJELEDE
Authorized Official - Middle Name:
Authorized Official - Last Name:EHIKHAMENOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-858-2256
Mailing Address - Street 1:2361 92ND ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11369-1118
Mailing Address - Country:US
Mailing Address - Phone:917-858-2256
Mailing Address - Fax:516-415-7857
Practice Address - Street 1:2361 92ND ST
Practice Address - Street 2:
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11369-1118
Practice Address - Country:US
Practice Address - Phone:917-858-2256
Practice Address - Fax:516-415-7857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies