Provider Demographics
NPI:1053895516
Name:FRONTLINE DME INC.
Entity type:Organization
Organization Name:FRONTLINE DME INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:
Authorized Official - Last Name:YUDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-239-2522
Mailing Address - Street 1:241 MILL ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1209
Mailing Address - Country:US
Mailing Address - Phone:516-239-2522
Mailing Address - Fax:
Practice Address - Street 1:241 MILL ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:11559-1209
Practice Address - Country:US
Practice Address - Phone:516-239-2522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies