Provider Demographics
NPI:1164504460
Name:NE-MEDICAL SUPPLY USA, INC.
Entity Type:Organization
Organization Name:NE-MEDICAL SUPPLY USA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:ROBYN
Authorized Official - Last Name:WAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-210-5915
Mailing Address - Street 1:621 NW 53RD ST
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-8235
Mailing Address - Country:US
Mailing Address - Phone:561-210-5915
Mailing Address - Fax:561-210-7880
Practice Address - Street 1:3811 SW 47TH AVE
Practice Address - Street 2:SUITE 629
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-2819
Practice Address - Country:US
Practice Address - Phone:561-210-5915
Practice Address - Fax:561-210-7880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22:014443336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy