Organization
STATEWIDE MEDICAL AND SURGICAL SUPPLIES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MERCEDES DESORMEAUX (C.E.O)
(718) 257-8810
Entity
Organization
Contact information
Practice address
9602 AVENUE L, BROOKLYN, NY 11236-4813
(718) 257-8810
(718) 257-8806
Mailing address
9602 AVENUE L, BROOKLYN, NY 11236-4808
(718) 257-8810
(718) 257-8806
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
1118484
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02291367
—
NY
Enumeration date
01/30/2007
Last updated
12/07/2007
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