Organization
LAINE MEDICAL SUPPLIES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA LAINE (OWNER)
(718) 413-4722
Entity
Organization
Contact information
Practice address
11317 COLFAX ST, QUEENS VILLAGE, NY 11429-2218
(718) 413-4722
(718) 228-9471
Mailing address
11317 COLFAX ST, QUEENS VILLAGE, NY 11429-2218
(718) 413-4722
(718) 228-9471
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Enumeration date
10/11/2019
Last updated
01/09/2020
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