Provider Demographics
NPI:1992345219
Name:MED SUPPORT INC
Entity type:Organization
Organization Name:MED SUPPORT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:FANG LIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-673-1990
Mailing Address - Street 1:619 W 176TH ST OFC A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-7829
Mailing Address - Country:US
Mailing Address - Phone:212-923-2191
Mailing Address - Fax:718-969-0016
Practice Address - Street 1:619 W 176TH ST OFC A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-7829
Practice Address - Country:US
Practice Address - Phone:212-923-2191
Practice Address - Fax:718-969-0016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies