Provider Demographics
NPI:1093035503
Name:SENT FROM ABOVE HOME MEDICAL SUPPLY STORE
Entity Type:Organization
Organization Name:SENT FROM ABOVE HOME MEDICAL SUPPLY STORE
Other - Org Name:SENT FROM ABOVE HOME MEDICAL SUPPLY STORE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-622-8388
Mailing Address - Street 1:813 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:LAKE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33403-2919
Mailing Address - Country:US
Mailing Address - Phone:561-622-8388
Mailing Address - Fax:561-622-8296
Practice Address - Street 1:813 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:LAKE PARK
Practice Address - State:FL
Practice Address - Zip Code:33403-2919
Practice Address - Country:US
Practice Address - Phone:561-622-8388
Practice Address - Fax:561-622-8296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies