Provider Demographics
NPI:1730894650
Name:MIDHUDSON MEDICAL TRADING CORP
Entity type:Organization
Organization Name:MIDHUDSON MEDICAL TRADING CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:DME SPECIALIST
Authorized Official - Phone:917-626-8395
Mailing Address - Street 1:440 BOULEVARD # 1B
Mailing Address - Street 2:
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604-1500
Mailing Address - Country:US
Mailing Address - Phone:917-626-8395
Mailing Address - Fax:
Practice Address - Street 1:440 BOULEVARD # 1B
Practice Address - Street 2:
Practice Address - City:HASBROUCK HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07604-1500
Practice Address - Country:US
Practice Address - Phone:917-626-8395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies