| Organization Name: | PATRIOT MEDICAL SUPPLY, INC. |
| NPI Number: | 1194034371 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | YURY SHRAYBMAN (MANAGER) |
| Mailing Address: | 380 Red Lion Rd Suite 203 Huntingdon Valley |
| State: | PA US |
| Postal Code: | 190066451 |
| Phone Number: | 2158219495 |
| Fax Number: | 2156777801 |
| NPI Enumeration Date: | 10/05/2010 |
| NPI Last Update Date: | 04/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332B00000X |
| License Number: | 3000008635 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |