Provider Demographics
NPI:1730903303
Name:ACRICON HEALTH LLC
Entity type:Organization
Organization Name:ACRICON HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:IDIMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-670-7433
Mailing Address - Street 1:109 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5355
Mailing Address - Country:US
Mailing Address - Phone:347-805-5276
Mailing Address - Fax:845-670-7477
Practice Address - Street 1:212 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-6435
Practice Address - Country:US
Practice Address - Phone:347-805-5276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies