Provider Demographics
NPI:1376937748
Name:ABC MEDICAL SUPPLIES
Entity Type:Organization
Organization Name:ABC MEDICAL SUPPLIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RONEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BENIZRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-933-7885
Mailing Address - Street 1:2500 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-2885
Mailing Address - Country:US
Mailing Address - Phone:347-933-7885
Mailing Address - Fax:
Practice Address - Street 1:2500 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-2885
Practice Address - Country:US
Practice Address - Phone:347-933-7885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-24
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies