Provider Demographics
NPI:1376132548
Name:WSB MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:WSB MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BASILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-330-8776
Mailing Address - Street 1:3200 N FEDERAL HWY STE 206-20
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6049
Mailing Address - Country:US
Mailing Address - Phone:877-631-1704
Mailing Address - Fax:
Practice Address - Street 1:3200 N FEDERAL HWY STE 206-20
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6049
Practice Address - Country:US
Practice Address - Phone:877-631-1704
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies