Provider Demographics
NPI:1083853774
Name:RAINBOW MEDICAL EQUIPMENT & SUPPLIES
Entity Type:Organization
Organization Name:RAINBOW MEDICAL EQUIPMENT & SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEVACQUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-795-0036
Mailing Address - Street 1:14786 HORSESHOE TRACE
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414
Mailing Address - Country:US
Mailing Address - Phone:561-795-0036
Mailing Address - Fax:561-790-1668
Practice Address - Street 1:14786 HORSESHOE TRCE
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-7843
Practice Address - Country:US
Practice Address - Phone:561-795-0036
Practice Address - Fax:561-790-1668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-19
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies