Provider Demographics
NPI:1184230567
Name:MEDIC SUPPLY CORP
Entity Type:Organization
Organization Name:MEDIC SUPPLY CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINCENZO
Authorized Official - Middle Name:
Authorized Official - Last Name:NODINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-613-0712
Mailing Address - Street 1:7777 DAVIE ROAD EXT STE 302A-8
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-2513
Mailing Address - Country:US
Mailing Address - Phone:954-613-0712
Mailing Address - Fax:
Practice Address - Street 1:7777 DAVIE ROAD EXT STE 302A-8
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2513
Practice Address - Country:US
Practice Address - Phone:954-613-0712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies