Provider Demographics
NPI:1235175670
Name:ABEL MEDICAL EQUIPMENT&SUPPLY CO
Entity Type:Organization
Organization Name:ABEL MEDICAL EQUIPMENT&SUPPLY CO
Other - Org Name:ISN'T SHE LOVELY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:772-335-9977
Mailing Address - Street 1:10806 S US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-6405
Mailing Address - Country:US
Mailing Address - Phone:772-335-9977
Mailing Address - Fax:772-335-9994
Practice Address - Street 1:10806 S US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-6405
Practice Address - Country:US
Practice Address - Phone:772-335-9977
Practice Address - Fax:772-335-9994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1301332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0579660004Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER