Provider Demographics
NPI:1073860094
Name:MEDICAL SUPPLY SHOPPE OF THE PALM BEACHES INC.
Entity Type:Organization
Organization Name:MEDICAL SUPPLY SHOPPE OF THE PALM BEACHES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MABEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-301-4888
Mailing Address - Street 1:602 N US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:TEQUESTA
Mailing Address - State:FL
Mailing Address - Zip Code:33469-2374
Mailing Address - Country:US
Mailing Address - Phone:888-301-4888
Mailing Address - Fax:888-398-3978
Practice Address - Street 1:602 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:TEQUESTA
Practice Address - State:FL
Practice Address - Zip Code:33469-2374
Practice Address - Country:US
Practice Address - Phone:888-301-4888
Practice Address - Fax:888-398-3978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies