| Organization Name: | PSC MEDICAL SUPPLY GROUP INC |
| NPI Number: | 1205981685 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PEDRO SEVERINO (MANAGER) |
| Mailing Address: | 9806 101st Ave Ozone Park |
| State: | NY US |
| Postal Code: | 114162607 |
| Phone Number: | 7183226600 |
| Fax Number: | 7183227846 |
| NPI Enumeration Date: | 01/24/2007 |
| NPI Last Update Date: | 08/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BP3500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Parenteral & Enteral Nutrition |
| Taxonomy Definition: | |