Provider Demographics
NPI:1033851506
Name:MED DEPT INC
Entity Type:Organization
Organization Name:MED DEPT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:TAINA
Authorized Official - Middle Name:SHANIA
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-590-0977
Mailing Address - Street 1:20451 NW 2ND AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2539
Mailing Address - Country:US
Mailing Address - Phone:800-915-5924
Mailing Address - Fax:954-637-2627
Practice Address - Street 1:20451 NW 2ND AVE STE 209
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-2539
Practice Address - Country:US
Practice Address - Phone:800-915-5924
Practice Address - Fax:954-637-2627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-13
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies