Provider Demographics
NPI:1083985675
Name:MED SUPPLY CABINET, INC
Entity Type:Organization
Organization Name:MED SUPPLY CABINET, INC
Other - Org Name:AESBAR MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:DORAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-393-8672
Mailing Address - Street 1:3734 131ST AVE N
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33762-4233
Mailing Address - Country:US
Mailing Address - Phone:877-799-6863
Mailing Address - Fax:866-799-6863
Practice Address - Street 1:411 CAREDEAN DR
Practice Address - Street 2:SUITE A
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-1317
Practice Address - Country:US
Practice Address - Phone:877-799-6863
Practice Address - Fax:866-799-6863
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MED SUPPLY CABINET, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-01-13
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL326862332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies