Provider Demographics
NPI:1083075246
Name:COMPREHENSIVE MEDICAL SUPPLY COMPANY LLC
Entity Type:Organization
Organization Name:COMPREHENSIVE MEDICAL SUPPLY COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:MERKLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-783-7100
Mailing Address - Street 1:1101 E SAMPLE RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-5104
Mailing Address - Country:US
Mailing Address - Phone:954-783-7100
Mailing Address - Fax:
Practice Address - Street 1:1101 E SAMPLE RD
Practice Address - Street 2:SUITE 114
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-5104
Practice Address - Country:US
Practice Address - Phone:954-783-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-16
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0051275-00332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE21531Medicare UPIN
FL0527990001Medicare NSC
FLK3690Medicare PIN