Organization
NEW LIFE VAN, AUTO AND TRUCK MODIFICATION
Active
Parent organization
NEW LIVE VAN, AUTO AND TRUCK MODIFICATION
Organization subpart
Yes
Provider details
NPI number
Legal business name
NEW LIVE VAN, AUTO AND TRUCK MODIFICATION
Authorized official
MRS. PAMELA SUE BURNS (PRESIDENT)
(845) 361-1244
Entity
Organization
Contact information
Practice address
971 STATE ROUTE 42, SPARROW BUSH, NY 12780-5014
(845) 361-1244
Mailing address
258 VAN KEUREN AVE, PINE BUSH, NY 12566-6603
(845) 361-1244
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/23/2012
Last updated
10/23/2012
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