Organization
THE MEDICAL STORE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOUIS TIRONI (PRESIDENT)
(845) 469-5550
Entity
Organization
Contact information
Practice address
78 BROOKSIDE AVE, SUITE 139, CHESTER, NY 10918-1059
(845) 469-5550
(845) 469-6088
Mailing address
78 BROOKSIDE AVE, SUITE 139, CHESTER, NY 10918-1059
(845) 469-5550
(845) 469-6088
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01211370
—
NY
Enumeration date
12/20/2006
Last updated
06/26/2008
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