Provider Demographics
NPI:1922818772
Name:FARIDI MEDICAL SUPPLIES LLC
Entity type:Organization
Organization Name:FARIDI MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:TARIQ
Authorized Official - Last Name:FARIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-801-2224
Mailing Address - Street 1:73 JOSHUA HL
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06095-3469
Mailing Address - Country:US
Mailing Address - Phone:860-801-2224
Mailing Address - Fax:
Practice Address - Street 1:43 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2412
Practice Address - Country:US
Practice Address - Phone:860-523-1076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies