Provider Demographics
NPI:1316028053
Name:S A S B INC
Entity Type:Organization
Organization Name:S A S B INC
Other - Org Name:OKEECHOBEE DISCOUNT DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO - RPH.
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:D
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH - CRPH
Authorized Official - Phone:863-763-5100
Mailing Address - Street 1:203 SW PARK ST
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-4160
Mailing Address - Country:US
Mailing Address - Phone:863-763-5100
Mailing Address - Fax:863-763-7550
Practice Address - Street 1:203 SW PARK ST
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-4160
Practice Address - Country:US
Practice Address - Phone:863-763-5100
Practice Address - Fax:863-763-7550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPH8238332BC3200X, 332BP3500X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105007901Medicaid
FL105007901Medicaid