Organization Name: | REVIVAL DURABLE MEDICAL EQUIPMENT INC |
NPI Number: | 1003247297 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EUNICE K PARK (PRESIDENT) |
Mailing Address: | 136-69 41ave 1fl Flushing |
State: | NY US |
Postal Code: | 113552433 |
Phone Number: | 7188881535 |
Fax Number: | 7188889154 |
NPI Enumeration Date: | 12/12/2013 |
NPI Last Update Date: | 08/20/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BC3200X |
License Number: | 1462251 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Customized Equipment |
Taxonomy Definition: |