Provider Demographics
NPI:1093018996
Name:RENEW MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:RENEW MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHILEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-334-7714
Mailing Address - Street 1:5600 MARINER ST
Mailing Address - Street 2:215
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3471
Mailing Address - Country:US
Mailing Address - Phone:813-506-6000
Mailing Address - Fax:877-263-6851
Practice Address - Street 1:5600 MARINER ST
Practice Address - Street 2:215
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3471
Practice Address - Country:US
Practice Address - Phone:813-506-6000
Practice Address - Fax:877-263-6851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-15
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies