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Organization
REVOLUTION MEDICAL SUPPLY
Active
Organization
REVOLUTION MEDICAL SUPPLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NDUKA NDUKA (OWNER)
(469) 348-6910
Entity
Organization
Contact information
Practice address
994 E 180TH ST, SUITE #4F, BRONX, NY 10460-2248
(469) 348-6910
Mailing address
PO BOX 494333, GARLAND, TX 75049-4333
(469) 348-6910
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
13417795909700
NY
Other
Enumeration date
06/19/2010
Last updated
07/27/2010
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