Provider Demographics
NPI:1396817284
Name:CENTURY SUPPLY SALES INC
Entity Type:Organization
Organization Name:CENTURY SUPPLY SALES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:SAN
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-667-4111
Mailing Address - Street 1:1550 S DIXIE HWY
Mailing Address - Street 2:SUITE 216-A
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126
Mailing Address - Country:US
Mailing Address - Phone:305-667-4111
Mailing Address - Fax:305-667-4121
Practice Address - Street 1:1550 S DIXIE HWY
Practice Address - Street 2:SUITE 216-A
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126
Practice Address - Country:US
Practice Address - Phone:305-667-4111
Practice Address - Fax:305-667-4121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL5937010001Medicare NSC