Organization
ELITE MEDICAL SUPPLY GROUP LLC
Active
Parent organization
ELITE MEDICAL SUPPLY GROUP LLC
Other names
Elite Medical Supply
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELITE MEDICAL SUPPLY GROUP LLC
Authorized official
MIKE KOSTYLEV (PRESIDENT)
(347) 414-5700
Entity
Organization
Contact information
Practice address
1071 BRIGHTON BEACH AVE, BROOKLYN, NY 11235-5602
(347) 414-5700
(347) 406-6100
Mailing address
1071 BRIGHTON BEACH AVE, BROOKLYN, NY 11235-5602
(347) 414-5700
(347) 406-6100
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/09/2019
Last updated
03/06/2022
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