Provider Demographics
NPI:1164479382
Name:E & E MEDICAL SERVICES CORP
Entity Type:Organization
Organization Name:E & E MEDICAL SERVICES CORP
Other - Org Name:ELBIA'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELBIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-883-8848
Mailing Address - Street 1:240 E 1ST AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4963
Mailing Address - Country:US
Mailing Address - Phone:305-883-8848
Mailing Address - Fax:305-883-1648
Practice Address - Street 1:240 E 1ST AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4963
Practice Address - Country:US
Practice Address - Phone:305-883-8848
Practice Address - Fax:305-883-1648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHME 1312507332B00000X
FLPH 240583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5252410001Medicare NSC