Organization
REGO MED SUPPLIES CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GABRIYEL ADZHIASHVILI (OWNER)
(917) 304-6657
Entity
Organization
Contact information
Practice address
9937 63RD AVE, REGO PARK, NY 11374-1942
(917) 304-6657
Mailing address
9937 63RD AVE, REGO PARK, NY 11374-1942
(917) 304-6657
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
33
NY
Other
Enumeration date
09/14/2011
Last updated
09/14/2011
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