Southside Medical Supply, Llc

LBN: Southside Medical Supply, Llc
Southside Medical Supply, Llc is an health care organization with primary practice located at 1900 S. Clinton Ave. Ste 320 , Rochester NY 14618-5719. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Parenteral & Enteral Nutrition, Suppliers / Prosthetic/Orthotic Supplier. Suppliers / Durable Medical Equipment & Medical Supplies is the primary health care specialty. Southside Medical Supply, Llc can be contacted via phone (585) 271-7141, or through Doles, Kelly A via phone (585) 770-2281.

Contact Information

Primary practice address
1900 S. Clinton Ave. Ste 320 Rochester NY 14618-5719
Phone: (585) 271-7141
Fax: (585) 419-6163
Website:
Map and Directions
Authorized official contact:
Name: Doles, Kelly A
Phone: (585) 770-2281

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Parenteral & Enteral Nutrition 332BP3500X
Suppliers / Prosthetic/Orthotic Supplier 335E00000X

Profile Details

NPI number 1568413656
LBN Legal business name Southside Medical Supply, Llc
DBA Doing business as
Authorized official Doles, Kelly A
Entity Organization
Organization subpart 1 No
Enumeration date May 13th, 2006
Last updated Nov 25th, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568413656 NPPES
New York Other 182719GD PREFERRED CARE
New York MEDICAID 84V PREFERRED CARE
New York Other 7273762 PREFERRED CARE
New York MEDICAID 02742689 PREFERRED CARE
New York Other P0170059SS PREFERRED CARE

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