Provider Demographics
NPI:1144833955
Name:DEDICATED MEDICAL PROVIDERS LLC
Entity type:Organization
Organization Name:DEDICATED MEDICAL PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-975-1129
Mailing Address - Street 1:55 WALNUT ST STE 104-C
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07648-1335
Mailing Address - Country:US
Mailing Address - Phone:201-975-1129
Mailing Address - Fax:
Practice Address - Street 1:55 WALNUT ST STE 104-C
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07648-1335
Practice Address - Country:US
Practice Address - Phone:201-975-1129
Practice Address - Fax:201-987-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies