Provider Demographics
NPI:1972724938
Name:MAXI AIDS INC
Entity type:Organization
Organization Name:MAXI AIDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CUSTOMER SERVICE SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:TERESE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-752-0521
Mailing Address - Street 1:42 EXECUTIVE BLVD
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-4710
Mailing Address - Country:US
Mailing Address - Phone:631-752-0521
Mailing Address - Fax:631-752-0689
Practice Address - Street 1:42 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-4710
Practice Address - Country:US
Practice Address - Phone:631-752-0521
Practice Address - Fax:631-752-0689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0842630001Medicare ID - Type Unspecified