Provider Demographics
NPI:1346767399
Name:PREFERRED MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:PREFERRED MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-326-7696
Mailing Address - Street 1:10235 W SAMPLE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3980
Mailing Address - Country:US
Mailing Address - Phone:888-958-2940
Mailing Address - Fax:
Practice Address - Street 1:10235 W SAMPLE RD STE 107
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3980
Practice Address - Country:US
Practice Address - Phone:888-958-2940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-29
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies