Provider Demographics
NPI:1891848198
Name:EAST COAST SURGICAL & MEDICAL SUPPLY, LLC
Entity type:Organization
Organization Name:EAST COAST SURGICAL & MEDICAL SUPPLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-487-1812
Mailing Address - Street 1:165 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-7124
Mailing Address - Country:US
Mailing Address - Phone:201-487-1812
Mailing Address - Fax:845-623-8233
Practice Address - Street 1:165 MAIN ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-7124
Practice Address - Country:US
Practice Address - Phone:201-487-1812
Practice Address - Fax:845-623-8233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies