Provider Demographics
NPI:1396996724
Name:DURABLE MEDICAL SUPPLY INC.
Entity type:Organization
Organization Name:DURABLE MEDICAL SUPPLY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OSABUOHIEN
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:IROWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-454-4751
Mailing Address - Street 1:750 BROADWAY 1ST FLOOR SUITE F
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514
Mailing Address - Country:US
Mailing Address - Phone:973-345-5068
Mailing Address - Fax:973-345-5069
Practice Address - Street 1:750 BROADWAY 1ST FLOOR SUITE F
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514
Practice Address - Country:US
Practice Address - Phone:973-345-5068
Practice Address - Fax:973-345-5069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-03
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0400250791332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6195630001Medicare NSC