Provider Demographics
NPI:1033008875
Name:MEDIVANCE CARE LLC
Entity type:Organization
Organization Name:MEDIVANCE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SUBHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-309-9701
Mailing Address - Street 1:83 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:MILLTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08850-1845
Mailing Address - Country:US
Mailing Address - Phone:347-309-9701
Mailing Address - Fax:
Practice Address - Street 1:593 E 38TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-5612
Practice Address - Country:US
Practice Address - Phone:347-309-9701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies