Medtec Medical Supply, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MEDTEC MEDICAL SUPPLY, LLC

Practice address

623 River Rd
Suite 1R
Fair Haven, NJ 07704-3267

Phone

(732) 842-8220

Fax

(732) 842-8221

NPI assigned

Dec 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Peter Antonucci

Title

President

Phone

(732) 842-8220

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033278288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 RIVER RD",
            "address_2": "SUITE 1R",
            "city": "FAIR HAVEN",
            "state": "NJ",
            "postal_code": "077043267",
            "telephone_number": "732-842-8220",
            "fax_number": "732-842-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 RIVER RD",
            "address_2": "SUITE 1R",
            "city": "FAIR HAVEN",
            "state": "NJ",
            "postal_code": "077043267",
            "telephone_number": "732-842-8220",
            "fax_number": "732-842-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDTEC MEDICAL SUPPLY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANTONUCCI",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-842-8220"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lupon, LPC
• Jordon Lupon
• Sue Massie, ND
• Gregory Paul McDermott, DC
• Karly Ann McDermott, L.AC
• Danielle J Nardone, DO
• Nexderm
• Jennifer Norton, P.T.
• Shanley Kara O'Keefe, LAC
• Dominic Pamintuan, MD

• Durable Medical Equipment & Medical Supplies in Fair Haven, NJ
• Providers in Fair Haven, NJ by specialty
• Durable Medical Equipment & Medical Supplies in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.