Provider Demographics
NPI:1104843093
Name:TOTAL MEDICAL SUPPLIES, INC.
Entity Type:Organization
Organization Name:TOTAL MEDICAL SUPPLIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERNESTO
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-455-8883
Mailing Address - Street 1:129 SE 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-5551
Mailing Address - Country:US
Mailing Address - Phone:954-455-8883
Mailing Address - Fax:954-455-8389
Practice Address - Street 1:129 SE 1ST AVE
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-5551
Practice Address - Country:US
Practice Address - Phone:954-455-8883
Practice Address - Fax:954-455-8389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312627332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5441700001Medicare ID - Type UnspecifiedDME-PROVIDER NUMBER