Organization Active NPI

Civility Medical Supplies LLC

  • Durable Medical Equipment & Medical Supplies
  • Brewster, NY
National Provider Identifier
1861139545
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
CIVILITY MEDICAL SUPPLIES LLC
Practice address
155 Main Street.
Unit 307 a.
Brewster, NY 10509
Phone
(845) 363-8523
Fax
(845) 278-1930
NPI assigned
May 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Authorized official

Name
Mr. Daryn E Clark
Title
Managing Member
Phone
(203) 947-6086

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Customized Equipment (DME) 332BC3200X
Nursing Facility Supplies (DME) 332BN1400X

Addresses

Primary practice location

155 Main Street.
Unit 307 a.
Brewster, NY 10509

Mailing address

155 Main Street.
Unit 307 a.
Brewster, NY 10509
Phone (845) 363-8523

National Provider Directory

National Provider Directory
Tax ID family
Civility Medical Supplies LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

155 Main St
Ste 307
Brewster, NY 10509
Phone (845) 202-3982

NPI Registry JSON

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652659200000",
    "number": "1861139545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 MAIN STREET.",
            "address_2": "UNIT 307 A.",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "10509",
            "telephone_number": "845-363-8523",
            "fax_number": "845-278-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MAIN STREET.",
            "address_2": "UNIT 307 A.",
            "city": "BREWSTER",
            "state": "NY",
            "postal_code": "10509",
            "telephone_number": "845-363-8523",
            "fax_number": "845-278-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIVILITY MEDICAL SUPPLIES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DARYN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "203-947-6086",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.