Crown Geriatrics Supply Corp

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

113082862 Issued in NY

Legal business name

CROWN GERIATRICS SUPPLY CORP

Practice address

1613 McDonald Ave
Brooklyn, NY 11230-6310

Phone

(718) 645-4433

Fax

(718) 645-7241

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Benjamin Webster

Title

Vice President

Phone

(917) 751-8965

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512432000000",
    "number": "1831201458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 58TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042027",
            "telephone_number": "917-751-8965",
            "fax_number": "718-701-5716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1613 MCDONALD AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306310",
            "telephone_number": "718-645-4433",
            "fax_number": "718-645-7241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROWN GERIATRICS SUPPLY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2017-12-05",
        "status": "A",
        "authorized_official_last_name": "WEBSTER",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "917-751-8965",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NY",
            "license": "113082862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01734990",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Crown Heights Medical Doctor PC
• Crown Heights P.T., O.T and SLP, PLLC
• Crown Heights Pharmacy Inc
• Crown Heights Pharmacy Inc

• Durable Medical Equipment & Medical Supplies in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Durable Medical Equipment & Medical Supplies in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.