Provider Demographics
NPI:1326494303
Name:DADE MEDICAL INC
Entity Type:Organization
Organization Name:DADE MEDICAL INC
Other - Org Name:INTEGRATED HOME INFUSION
Other - Org Type:Other Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-215-4264
Mailing Address - Street 1:3700 COMMERCE PARKWAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025
Mailing Address - Country:US
Mailing Address - Phone:844-215-4264
Mailing Address - Fax:844-215-4265
Practice Address - Street 1:3700 COMMERCE PKWY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-3912
Practice Address - Country:US
Practice Address - Phone:844-215-4264
Practice Address - Fax:844-215-4265
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DADE MEDICAL, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-05-10
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X, 3336S0011X, 3336S0011X
FLPH307243336H0001X, 3336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100124600Medicaid
2170548OtherPK