Organization Name: | GARDEN STATE SUPPLY |
NPI Number: | 1144352311 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANNE SHARON LEO (OWNER) |
Mailing Address: | 24 Union Avenue Lakehurst |
State: | NJ US |
Postal Code: | 087330084 |
Phone Number: | 7326579600 |
Fax Number: | 7326579400 |
NPI Enumeration Date: | 03/12/2007 |
NPI Last Update Date: | 07/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BX2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Oxygen Equipment & Supplies |
Taxonomy Definition: |