Provider Demographics
NPI:1417267634
Name:FIRST QUALITY MEDICAL SUPPLIES, INC
Entity Type:Organization
Organization Name:FIRST QUALITY MEDICAL SUPPLIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSANA
Authorized Official - Middle Name:ROSA
Authorized Official - Last Name:WEDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-262-7005
Mailing Address - Street 1:7262 SW 48TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-5525
Mailing Address - Country:US
Mailing Address - Phone:305-262-7005
Mailing Address - Fax:
Practice Address - Street 1:7262 SW 48TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-5525
Practice Address - Country:US
Practice Address - Phone:305-262-7005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-21
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1312136332B00000X, 332BP3500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL684437500Medicaid
FL009493700Medicaid
FL675522401Medicaid
FL675522400Medicaid